A new-generation, low-permeability flow diverting device for treatment of saccular aneurysms

作者：Mallik Ajit S; Nuss Katja; Kronen Peter W; Klein Karina; Karol Agnieszka; von Rechenberg Brigitte; Ruefenacht Daniel A; Wanke Isabel; Kulcsar Zsolt^*

来源：European Radiology, 2014, 24(1): 12-18.

DOI：10.1007/s00330-013-2970-3

• Flow diverter
• Aneurysm
• Stenting
• Thrombus
• Porosity
• Pore density

Objectives We report a preclinical comparative study of a 96-strand braided flow diverter.
Methods The 96-strand braided device was compared with the currently commercially available flow diverter with 48 strands. The devices were implanted across the neck of 12 elastase-induced aneurysms in New Zealand White rabbits and followed for 1 and 3 months (n=6 respectively). Aneurysm occlusion rates, parent artery stenosis and patency of jailed branch occlusions were assessed by angiography, histology and scanning electron microscopy studies.
Results It was feasible to navigate and implant the 96-strand device over the aneurysm orifice in all cases. At follow-up two aneurysms in the 48-strand vs. one in the 96-strand group were not occluded. This aneurysm from the 96-strand group however had a tracheal branch arising from the sac and showed a reverse remodelling of the vascular pouch at 3 months. In the occluded aneurysms, the parent artery was always completely reconstructed and the aneurysm orifice was sealed with neointimal tissue. No in-stent stenosis or jailed branch artery occlusion was observed.
Conclusions The 96-strand flow diverter proved to be safe, biocompatible and haemodynamically effective, induced stable occlusion of aneurysms and led to reverse remodelling of the parent artery.
Key points
Flow diversion has been introduced to improve endovascular treatment of cerebral aneurysms
A new low-permeability flow diverter is feasible for parent artery reconstruction.
The Silk 96 flow diverter appears effective at inducing aneurysm healing.
The covered branches remained patent at follow-up.

• 出版日期2014-1