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(Stroke. 2002;33:421.)
© 2002 American Heart Association, Inc.

Expedited Publications

In Situ Beta Radiation to Prevent Recanalization After Coil Embolization of Cerebral Aneurysms

Jean Raymond, MD; Philippe Leblanc, PhD; Anne-Cécile Desfaits, PhD; Igor Salazkin, MD; François Morel; Christian Janicki, PhD Sjoerd Roorda, PhD

From the Departments of Radiology (J.R.) and Physics (P.L., F.M., S.R.), University of Montreal; the Research Center (A-C.D., I.S.), University of Montreal Medical Centre; and the Department of Medical Physics (C.J.), McGill University Health Centre, Montreal General Hospital, Montreal, Quebec, Canada.

Correspondence to Jean Raymond MD, Department of Radiology, University of Montreal Medical Center, Notre-Dame Hospital, 1560 Sherbrooke East, room M-8203-1, Montreal, Quebec, H2L 4M1, Canada. E-mail dr_jean_raymond{at}hotmail.com

Background and Purpose— Endovascular treatment of cerebral aneurysms, a minimally invasive alternative to surgery, is too often followed by recanalization and recurrences. The purpose of this work was to assess if in situ beta radiation can inhibit recanalization after coil embolization.

Methods— Radioactive platinum coils (³²P-coils) were produced by ion implantation of ³²P. A single-coil arterial occlusion model was used to compare angiographic and pathological results at 1 to 12 weeks after nonradioactive and ³²P-coil embolization of maxillary, cervical, and vertebral arteries in 26 dogs. Coils of varying activities were used and results compared to define the minimal activity required to inhibit recanalization. Similar experiments were performed in 16 porcine maxillary and lingual and 8 rabbit axillary arteries. Results of ³²P-coil embolization of bifurcation aneurysms were then compared with embolization with nonradioactive coils in 12 dogs at 3 months.

Results— Nonradioactive coil embolization of canine arteries led to occlusion at 1 week, followed by recanalization at 2 weeks, which persisted at 3 months in all cases. ³²P-coils, ion-implanted with activities above 0.13 µCi/cm, led to persistent occlusion at 3 months in 80% of arteries. ³²P-coils ion-implanted with the same activity inhibited recanalization in porcine and rabbit arteries. Bifurcation aneurysms treated with ³²P-coils had better angiographic results at 3 months (P=0.006) than aneurysms treated with nonradioactive coils. Arteries occluded were filled with fibrous tissue at 3 months. Aneurysms embolized with ³²P-coils showed more complete neointimal coverage of the neck, without recanalization, as compared with aneurysms treated with nonradioactive coils.

Conclusion— In situ low-dose beta radiation inhibits recanalization after coil embolization and may improve long-term results of endovascular treatment of aneurysms.

Key Words: aneurysms • animal models • endovascular therapy • radiation • dogs

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