gms | German Medical Science

60th Annual Meeting of the German Society of Neurosurgery (DGNC)
Joint Meeting with the Benelux countries and Bulgaria

German Society of Neurosurgery (DGNC)

24 - 27 May 2009, Münster

Bare, bio-active, and hydrogel coated coils for endovascular treatment of experimentally induced aneurysms. Long-term histological and scanning electron microscopical results

Meeting Abstract

  • F.-J. Hans - Neurochirurgische Klinik, Universitätsklinikum der RWTH Aachen
  • U. Bürgel - Neurochirurgische Klinik, Universitätsklinikum der RWTH Aachen
  • B. Sellhaus - Abteilung für Neuropathologie, Universitätsklinikum der RWTH Aachen
  • M. Reinges - Neurochirurgische Klinik, Universitätsklinikum der RWTH Aachen
  • J. Gilsbach - Neurochirurgische Klinik, Universitätsklinikum der RWTH Aachen
  • T. Krings - Division of Neuroradiology, Toronto Western Hospital, Toronto, Canada

Deutsche Gesellschaft für Neurochirurgie. 60. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit den Benelux-Ländern und Bulgarien. Münster, 24.-27.05.2009. Düsseldorf: German Medical Science GMS Publishing House; 2009. DocP05-11

DOI: 10.3205/09dgnc303, URN: urn:nbn:de:0183-09dgnc3038

Published: May 20, 2009

© 2009 Hans et al.
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Outline

Text

Objective: Endovascular treatments of cerebral aneurysms with bare platinum coils have a higher rate of recurrence compared to surgical clipping. This may be due to the fact that histological and scanning electron microscopical results following embolization failed to demonstrate neoendothelialization over the aneurysm neck unable to reconstruct the vessel wall. In the present study we tried to elucidate whether the use of modified coils resulted in a better rate of reconstructing the vessel wall over the aneurysm orifice in experimental aneurysms.

Methods: Aneurysms were created in 20 rabbits by intraluminal elastase incubation of the common carotid artery. Five animals each were assigned to the following groups: Untreated, Bare platinum Coils, bioactive coils with polyglycolic/polylactic acid coating, and hydrogel-coated platinum coils. After twelve months, angiography, histology, and scanning electron microscopy were performed.

Results: No neoendothelial layer was visualized in the bioactive and in the bare coil groups with a tendency to an increased layering of fibroblasts along the bioactive coils at the aneurysm fundus. However, at the aneurysm neck perfused clefts were present and although a thin fibrinous layer was present over some coils, no bridging neointima or neoendothelium was noted over different coils. Following loose hydrogel coiling, a complete obliteration of the aneurysm was present with neoendothelialization present over different coil loops.

Conclusions: The study demonstrates that with surface coil modifications complete and stable aneurysm obliteration may become possible. A smooth and dense surface over the aneurysm neck may be necessary for endothelial cells to bridge the aneurysm neck and to lead to vessel wall reconstruction.