gms | German Medical Science

57th Annual Meeting of the German Society of Neurosurgery
Joint Meeting with the Japanese Neurosurgical Society

German Society of Neurosurgery (DGNC)

11 - 14 May, Essen

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Long-term in-vivo validation of a new stent system assisting coil embolisation of broad based in elastase-induced aneurysms

Langzeit-in-vivo-Validierung eines neuen Stentsystems zur kombinierten Embolisation breitbasiger Aneurysmen

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  • corresponding author W. Becker - Institut für Diagnostische und Interventionelle Radiologie und Neuroradiologie, Universitätsklinikum Essen
  • S. Goericke - Institut für Diagnostische und Interventionelle Radiologie und Neuroradiologie, Universitätsklinikum Essen
  • N. Blechschmid - Institut für Diagnostische und Interventionelle Radiologie und Neuroradiologie, Universitätsklinikum Essen
  • B. Einsfelder - Institut für Pathologie, Bergmannsheil Bochum, Ruhr-Universität Bochum
  • K. Müller - Institut für Pathologie, Bergmannsheil Bochum, Ruhr-Universität Bochum
  • I. Wanke - Institut für Diagnostische und Interventionelle Radiologie und Neuroradiologie, Universitätsklinikum Essen
  • M. Forsting - Institut für Diagnostische und Interventionelle Radiologie und Neuroradiologie, Universitätsklinikum Essen
  • A. Dörfler - Neuroradiologische Abteilung, Universitätsklinikum Erlangen

Deutsche Gesellschaft für Neurochirurgie. Japanische Gesellschaft für Neurochirurgie. 57. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), Joint Meeting mit der Japanischen Gesellschaft für Neurochirurgie. Essen, 11.-14.05.2006. Düsseldorf, Köln: German Medical Science; 2006. DocSO.02.05

The electronic version of this article is the complete one and can be found online at: http://www.egms.de/en/meetings/dgnc2006/06dgnc169.shtml

Published: May 8, 2006

© 2006 Becker et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

Outline

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Objective: Experimental in-vivo validation of a new stent system designed for treatment of broad-based aneurysms. After deployment through a microcatheter it is fully-retrievable due to an electrolytically detachable junction zone at the delivery wire, thus providing good control.

Methods: 22 aneurysms with a mean dome/neck ratio 0.9±0.3 were created in Chincilla bastard rabbits by endoluminal incubation of porcine elastase. All aneurysms were treated by coil embolisation through the struts of the stent (3 - 4mm diameter, 10mm length) bridging the neck of the aneurysm. Evaluation focused on stent delivery, performance during coil-embolisation, patency and cellular response. Follow-up imaging was performed using DSA, contrast-enhanced MRA (CEMRA), TOF-MRA (TOF), and CT-angiography (CTA) at the end of evaluation period. 10 subjects were sacrificed after 4 weeks (n=10), 10 after 3 months (n=10) followed by histological examination.

Results: Exact stent placement followed by complete aneurysm embolisation was possible in all animals. No displacement of the stent was noted during the procedure and follow-up. We observed no procedural complications, especially no thromboembolic ones. Two rabbits died within days after stenting due to pulmonary edema. Follow-up imaging at 4 weeks and three months demonstrated all arteries patent and complete aneurysm occlusion for the remaining 20 animals confirmed by histology. Mean luminal loss of diameter proximal to the aneurysm neck was 0.15±0.14mm and 0.17±0.13mm distally. After three months it was 0.26±0.25mm and 0.28±0.15mm. Non-invasive imaging using DSA, MRA, and CTA was feasible in this stent system.

Conclusions: Our data indicate that this new stent system is a valuable device for safe and controlled treatment of broad based aneurysms. Due to its retrievability, the stent provides very good control. The luminal loss of diameter within the stent is moderate in long-term follow-up.