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(Stroke. 2003;34:1262.)
© 2003 American Heart Association, Inc.

Original Contributions

Beta Radiation and Inhibition of Recanalization After Coil Embolization of Canine Arteries and Experimental Aneurysms

How Should Radiation Be Delivered?

Jean Raymond, MD; Philippe Leblanc, PhD; François Morel; Igor Salazkin, MD; Guylaine Gevry, BSc Sjoerd Roorda, PhD

From the Department of Radiology (J.R.) and Centre de Recherche (J.R., P.L., F.M., I.S., G.G.), Centre Hospitalier de l’Université de Montréal, Hôpital Notre-Dame, and the Physics Department (S.R.), Université de Montréal, Montreal, Quebec, Canada.

Reprint requests to Jean Raymond, MD, Interventional Neuroradiology Research Laboratory, Centre Hospitalier de l’Université de Montréal, Hôpital Notre-Dame, 1560 Sherbrooke St E, Room M-8203, Montreal, Quebec, Canada H2L 4M1. E-mail dr_jean_raymond{at}hotmail.com

Background and Purpose— Beta radiation prevents recanalization after coil embolization. We sought to determine the effects of varying coil caliber, length, activity of ³²P per centimeter of coil or per volume, and spatial distribution of coils on recanalization.

Methods— We studied the angiographic evolution of 81 canine maxillary, cervical, and vertebral arteries implanted with a variety of nonradioactive (n=29 arteries) or radioactive (n=52) devices. We compared 1- or 2-caliber 0.015 or 0.010 coils ion-implanted or not with 3 different activity levels (0.05 to 0.08, 0.06 to 0.12, 0.18 to 0.32 µCi/cm) of ³²P and totaling 4, 8, and 16 cm in length for the same arterial volume. We also compared inhibition of recanalization by beta radiation delivered by stents, after coil occlusion proximal to or within the stent, with that delivered by coils placed within nonradioactive stents. We finally studied the angiographic evolution of canine lateral wall carotid aneurysms treated with 1 or 2 stents of various activity levels positioned inside the parent artery across the neck. Animals were killed at 4 and 12 weeks for macroscopic photography and pathological examination.

Results— All arteries (29 of 29) occluded with nonradioactive devices were recanalized, while 49 of 52 arteries (94%) implanted with ³²P devices were occluded at 4 weeks. All aneurysms treated with stents, radioactive or not, demonstrated residual filling of the sac or of channels leading to the aneurysms at follow-up angiography at 4 weeks.

Conclusions— The recanalization process found in the canine arterial occlusion model is minimally affected by coil caliber, number, and length or packing density. Beta radiation reliably inhibits this process, but thrombosis is an essential condition for the efficacy of a radioactive coil strategy.

Key Words: aneurysm • angiography • cerebral aneurysm • endovascular therapy • radiation • dogs

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