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Submitted on September 5, 2007
From the Departments of Neurosurgery (C.N.I., J.M., K.R.H., J.Y., E.I.L., L.N.H., S.R., J.M.), Radiology (C.N.I., D.R.B., E.I.L., L.N.H., S.R.), and Pathology (J.K.) and Toshiba Stroke Research Center (C.N.I., A.P., K.R.H., D.R.B., J.Y., E.I.L., L.N.H., S.R., J.M.), School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York; and the Department of Neurosurgery (J.Y., E.I.L., L.N.H., J.M.), Millard Fillmore Gates Hospital, Kaleida Health, Buffalo, New York. * To whom correspondence should be addressed. E-mail: jmocco{at}buffns.com.
Background and Purpose—Intracranial aneurysm (IA) treatment through hemodynamic modification with novel stent designs is a burgeoning area of research. We present a feasibility study for a new low-porosity patch-containing stent designed to treat intracranial aneurysms. The device is deployed so the patch covers the aneurysm neck ensuring strong flow diversion away from the aneurysm while keeping a low probability of occlusion of perforating vessels. Methods—We created 17 side-wall aneurysms in 6 dogs, 2 per carotid artery if animal size permitted. Twelve proximal aneurysms were treated with AVSs: 5 distal aneurysms were untreated, serving as controls against self-thrombosis; 7 treated aneurysms were fully-covered; and 5 were partially-covered. After 4 weeks, a final angiogram was performed and aneurysms were explanted. Angiograms acquired pre- and posttreatment and at 4-week follow-up were analyzed quantitatively using normalized time-density curves (NTDC). Cone-beam micro-CT and histological specimen analysis were then performed. Results—Posttreatment, NTDC average peaks dropped to 45% of initial values for the partially-covered aneurysms and 78% for the fully-covered aneurysms. Cone-beam micro-CT imaging performed at 4 weeks posttreatment showed partial thrombosis in 4 of 5 partially-covered aneurysms and complete thrombosis in all fully-covered aneurysms. Histology revealed neointimal coverage of all asymmetrical patch regions and thrombus formation in both fully- and partially-covered aneurysms. Four-week follow-up was not done for 1 animal (2 controls, 2 treated) that expired because of groin hemorrhage and for another animal (1 aneurysm) with an occluded carotid. Conclusions—We demonstrate aneurysmal blood flow diversion using a new low-porosity patch-containing asymmetrical vascular stent in a canine side-wall aneurysm model. Overall results are encouraging and support continued AVS development.
Revised on October 27, 2007
Accepted on December 6, 2007
Asymmetric Vascular Stent. Feasibility Study of a New Low-Porosity Patch-Containing Stent
Ciprian N. Ionita PhD;
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