Biodegradable flow-diverting device for the treatment of intracranial aneurysm: short-term results of a rabbit experiment

Wang, Kuizhong; Yuan, Shaoji; Xuping, Zhang; Liu, Qiang; Zhong, Qing; Zhang, Rongwei; Lu, Pengfei; Ji-wen, LI

doi:10.1007/s00234-013-1150-0

Cited by 18 publications

(12 citation statements)

References 20 publications

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“…To improve mechanical properties of absorbable stents, others have coated stents with a bioabsorbable polyurethane elastomer and implemented an axial runner in the structure,16–18 although this requires curing and post-curing the rubber at elevated temperatures for extended periods of time which can be detrimental to the core biodegradable fibers. Wang et al developed a hybrid flow-diverting device made from a combination of absorbable and metal fibres 8. Unlike our device, however, their absorbable strands were made of PGA, and they added an equal number of PGA strands to an existing braid of metal fibers.…”

Section: Discussionmentioning

confidence: 99%

“…To date, there has been very little published on braided bioabsorbable polymeric stents used as flow diverters. In 2013, a report by Wang et al described the development of a partially biodegradable flow-diverting stent comprised of 24 metal fibers and 24 biodegradable polyglycolic acid fibers 8. In 2019, our group described the first self-expanding bioabsorbable flow-diverting stent for brain aneurysms, which was presented at the 2019 Joint Cerebrovascular Section Meeting 9.…”

Section: Introductionmentioning

confidence: 99%

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A novel self-expanding primarily bioabsorbable braided flow-diverting stent for aneurysms: initial safety results

Jamshidi

Rajabian

Avery

et al. 2019

J NeuroIntervent Surg

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IntroductionThe advent of metal flow-diverting stents has provided neurointerventionalists with an option for treating aneurysms without requiring manipulations within the aneurysm sac. The large amount of metal in these stents, however, can lead to early and late thrombotic complications, and thus requires long-term antiplatelet agents. Bioabsorbable stents have been postulated to mitigate the risk of these complications. Here we present early data on the first self-expandable primarily bioabsorbable stent for aneurysms.MethodsBraided stents were developed using poly-L-lactic acid fibers with material surface area similar to metal flow diverters. Crush resistance force, hemolysis, and thrombogenicity were determined and compared with existing commercial devices. Stents were deployed in infra-renal rabbit aortas to determine angiographic side branch patency and to study neointima formation for a 1-month follow-up period.ResultsCrush resistance force was determined to be on the order of existing commercial devices. Hemolytic behavior was similar to existing metal devices, and thrombogenicity was lower than metal flow-diverting stents. A smooth neointimal layer was found over the absorbable stent surface and all covered side branches were patent at follow-up.ConclusionThe design of self-expanding primarily bioabsorbable flow-diverting stents is possible, and preliminary safety data is consistent with a favorable profile in terms of mechanical behavior, hemocompatibility, side branch patency, and histological effects. Additional in vitro and long-term in vivo studies are in progress and will help determine aneurysm occlusion rates and absorption characteristics of the stent.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

A novel self-expanding primarily bioabsorbable braided flow-diverting stent for aneurysms: initial safety results

Jamshidi

Rajabian

Avery

et al. 2019

J NeuroIntervent Surg

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“…Using endovascular placement in a rabbit aneurysm model, Wang et al 17 reported effective aneurysm occlusion in all 12 of the animals treated with magnesium-alloy stents. Similarly, Wang et al 18 reported effective and safe treatment of carotid artery aneurysms in 13 rabbits using bioresorbable magnesium flow diverters. We confirmed good rates of aneurysm healing with brMAS treatment in our rat model.…”

Section: Discussionmentioning

confidence: 94%

Testing bioresorbable stent feasibility in a rat aneurysm model

Grüter

Täschler

Strange

et al. 2019

J NeuroIntervent Surg

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BackgroundAdvances in stent-assisted coiling have incrementally expanded endovascular treatment options for complex cerebral aneurysms. After successful coil consolidation and aneurysm occlusion, endovascular scaffolds are no longer needed. Thus, bioresorbable stents that disappear after aneurysm healing could avoid future risks of in-stent thrombosis and the need for lifelong antiplatelet therapy.ObjectiveTo assess the applicability and compatibility of a bioresorbable magnesium- alloy stent (brMAS) for assisted coiling.MethodsSaccular sidewall aneurysms were created in 84 male Wistar rats and treated with brMAS alone, brMAS + aspirin, or brMAS + coils + aspirin. Control groups included no treatment (natural course), solely aspirin treatment, or conventional cobalt–chromium stent + coils + aspirin treatment. After 1 and 4 weeks, aneurysm specimens were harvested and macroscopically, histologically, and molecularly examined for healing, parent artery perfusion status, and inflammatory reactions. Stent degradation was monitored for up to 6 months with micro-computed and optical coherence tomography.ResultsAneurysms treated with brMAS showed advanced healing, neointima formation, and subsequent stent degradation. Additional administration of aspirin sustained aneurysm healing while reducing stent-induced intraluminal and periadventitial inflammatory responses. No negative interaction was detected between platinum coils and brMAS. Progressive brMAS degradation was confirmed.ConclusionsbrMAS induced appropriate healing in this sidewall aneurysm model. The concept of using bioresorbable materials to promote complete aneurysm healing and subsequent stent degradation seems promising. These results should encourage further device refinements and clinical evaluation of this treatment strategy for cerebrovascular aneurysms.

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“…Many devices, such as coils and vascular stents, have been developed for the intravascular treatment of cerebral aneurysms . Covered or braided vascular stents have recently been extensively developed for this purpose . An ideal stent to treat cerebral aneurysms should take advantage of a drug delivery system.…”

Section: Discussionmentioning

confidence: 99%

Development of a stent capable of the controlled release of basic fibroblast growth factor and argatroban to treat cerebral aneurysms: In vitro experiment and evaluation in a rabbit aneurysm model

et al. 2019

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An ideal stent to treat cerebral aneurysms should have an antithrombotic effect on the inner stent blood-facing side and a tissue organization effect on the outer aneurysmal side of the stent. The objective of this study is to evaluate the feasibility of a drug containing stent in the in vivo treatment of cerebral aneurysms. Argatroban, an antithrombotic drug, is encapsulated in biodegradable poly (D,L-lactide-co-glycolide) (PLGA) microspheres for the controlled release with an in vitro study conducted to evaluate the drug release and anticoagulation behavior of released drug. Basic fibroblast growth factor (bFGF), an organization drug, is released from gelatin hydrogels. The stents are coated with gelatin hydrogels incorporating bFGF and PLGA microspheres containing argatroban, and applied to the carotid artery aneurysm of an elastase-induced rabbit model. Most of the aneurysm cavity is occupied by loose connective tissues in the group treated with drug-coated stents, whereas extensive massive hematomas are observed in the group treated with drug-free stents. The occurrence rate of in-stent thrombus is small in the drug-coated stents. The stent incorporating bFGF and PLGA microspheres containing argatroban is an effective device for cerebral aneurysm treatment.

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Biodegradable flow-diverting device for the treatment of intracranial aneurysm: short-term results of a rabbit experiment

Abstract: The PGA-FD was an effective device for the treatment of aneurysms and was safe for side branches at the 3-month follow-up.

Cited by 18 publications

References 20 publications

A novel self-expanding primarily bioabsorbable braided flow-diverting stent for aneurysms: initial safety results

A novel self-expanding primarily bioabsorbable braided flow-diverting stent for aneurysms: initial safety results

Testing bioresorbable stent feasibility in a rat aneurysm model

Development of a stent capable of the controlled release of basic fibroblast growth factor and argatroban to treat cerebral aneurysms: In vitro experiment and evaluation in a rabbit aneurysm model

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