Artikel
Efficacy and safety of alternative embolisation devices in an experimental aneurysm model
Die Effizienz und Sicherheit von alternativen Embolisationsmaterialien in einem experimentellen Aneurysmamodell
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Autoren
Veröffentlicht: | 4. Mai 2005 |
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Gliederung
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Objective
The most commonly used embolization device for intracerebral aneurysms are GDC-Coils. Other embolization devices like Matrix-Coils or the liquid embolization system ONYX(EVOH) are not used in daily routine for the treatment of intracranial aneurysms because they seem to bare more risks like thrombembolic events(ONYX) or harder handling(MATRIX). The aim of the study was to evaluate the efficiacy and safety of both alternative embolization devices under anticoagulation in comparison to GDC-Coils in an experimental aneurysm model in rabbits.
Methods
Aneurysms were induced in the right common carotid artery in rabbits. The animals were devided into 4 groups. Group 1 (n=5) served as a control group, no treatment. The aneurysms in Group 2 (n=10) were occluded with GDC-Coils. In group 3 (n=10) Matrix-Coils were used. In group 4 (n=10) a liquid emoblisation material (ONYX) was used to occlude the aneurysms. All animals received heparine during embolization and aspirine daily until sacrifice. Control angiographies were made after 3 and 6 months. The harvested aneurysms were stained and histologically evaluated.
Results
All aneurysms could be occluded, the control angiographies showed no sign of recanalization. These result were coherent with the histological results. Differences were most striking in the handling of the different materials. Wise the handling of Matrix-Coils is very similar to that of GDC(except for possible increased friction), the handling of Onyx is more demanding. Here a ballon assisted technique including de- and inflatation of the ballon is necessary (risk of ischemic event). The liquid character of the agent might induce more thromboembolic events.
Conclusions
The new embolization devices such as Matrix and Onyx are likely to produce similar good occlusion results. An anticoagulation with heparine/aspirine did not influence the occlusion rate. Thus anticoagulation plays an important part in the prevention of thromboembolic events. In contrast to GDC Coils the handling of Onyx is more demanding and it cannot safely be used in every localization.