Preliminary Results of the Luna Aneurysm Embolization System in a Rabbit Model: A New Intrasaccular Aneurysm Occlusion Device

Kwon, Soon Chan; Ding, Yong Hong; Dai, Daying; Kadirvel, Ramanathan; Lewis, Daniel C.; Kallmes, David F.

doi:10.3174/ajnr.a2314

Cited by 43 publications

(25 citation statements)

References 14 publications

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“…At 3 months, 7/8 (88%) aneurysms remained completely occluded. 73 Also at 3 months, microscopic examination showed 8/8 (100%) aneurysms had tissue completely covering the devise and neointima formation across the aneurysm neck. In a separate study 1 year later, Turk et al 74 compared the Luna AES to a vascular plug vascular plug in seven canines.…”

Section: Lunamentioning

confidence: 99%

“…Using a rabbit model, Kwon et al 73 embolized 12 aneurysms with the LUNA AES and performed digital subtraction angiography (DSA) pre and 5, 10, and 30 minutes post-implantation. At 30 minutes and 1 month, 10/12 (83%) were completely occluded.…”

Section: Lunamentioning

confidence: 99%

“…The aneurysms created in each animal study are likely more regular and easier to treat than complex human aneurysms, that may be irregular, wide-neck, or fusiform. 73 Second, little is known about precise sizing and positioning of the device given each aneurysms has a unique 3-dimensional morphology. Third, if incomplete occlusion is found, the interventionalist may have limited options for re-treatment, as coil placement into the lumen of the LUNA will not be possible.…”

Section: Lunamentioning

confidence: 99%

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Novel technologies in the treatment of intracranial aneurysms

Zuckerman¹,

Eli²,

Morone³

et al. 2014

Neurological Research

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The treatment of intracranial aneurysms has undergone precipitous expansion since the first detachable coils were used less than two decades ago. With rapidly expanding technology comes the need to keep all involved parties informed. The objective of our review is to provide a comprehensive, succinct overview of novel paradigms and devices used to treat intracranial aneurysms. We have divided these new technologies into: (1) coils, (2) flow diverters, (3) adjunctive balloon devices, and (4) stents.

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Section: Lunamentioning

confidence: 99%

Section: Lunamentioning

confidence: 99%

Section: Lunamentioning

confidence: 99%

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Novel technologies in the treatment of intracranial aneurysms

Zuckerman¹,

Eli²,

Morone³

et al. 2014

Neurological Research

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“…Preliminary clinical evidence with the WEB is promising, although it has been limited to a few small case series with relatively brief followup [1,2,10]. Published data on the Luna IFD are exclusively in preclinical studies [11]. The majority of the data on ANBRDs are also predominately comprised of in vitro and in vivo studies.…”

mentioning

confidence: 96%

Expanding the boundaries of endovascular aneurysm treatment: emerging technologies for wide-necked bifurcation aneurysms

Ding

2014

Acta Neurochir

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Dear Editor, I have read, with interest, a recently published article in Acta Neurochirurgica by Jeon et al. [9], titled 'Y-configuration double-stent-assisted coiling using two closed-cell stents for wide-neck basilar tip aneurysms'. This retrospective, multicenter cohort study reported the outcomes of 25 patients with widenecked basilar apex aneurysms who underwent Y-configuration stent-assisted coil embolization (Y-SACE). A minority of patients (12 %) were treated in the setting of subarachnoid hemorrhage (SAH). The mean dome and neck diameters were 11.4 and 7.5 mm, respectively. The incidence of procedural thromboembolic complications was 12 % (N=3, two unruptured and one ruptured aneurysm), and the mortality rate was 8 % (N=2, both ruptured aneurysms). After a mean clinical follow-up duration of 30 months, the rate of favorable neurological outcomes (Glasgow Outcome Scale score 4 or 5) was 96 % for unruptured aneurysms and 33 % for ruptured aneurysms. The immediate post-treatment rates of Raymond class I, II, and III outcomes were 36, 44, and 20 %, respectively. Of the 21 patients who underwent angiographic follow-up (mean duration 16 months), the rates of Raymond class I, II, and III were 81, 9.5, and 9.5 %, respectively. The authors' considerable experience in Y-SACE is a valuable contribution to the literature, given that the size of a recent Y-SACE multicenter study, comprised of seven centers in the United States, was 45 aneurysms, of which 39 were located at the basilar apex [7]. Widenecked bifurcation aneurysms (WNBA) present a unique challenge to neurointerventionalists due to a mismatch between mainstream neuroendovascular devices and bifurcation anatomy. As such, the goals of the following discussion are to (1) critically analyze the Y-SACE approach for WNBAs and (2) bring attention to emerging technologies which have been designed specifically for embolization of WNBAs.Endovascular treatment of WNBAs is rife with difficulties, including coil compaction, herniation and migration, thromboembolic occlusion of parent, branch, and perforator vessels, incomplete aneurysm occlusion, and major aneurysm recurrence [4,12]. Y-SACE is an adaptation of existing technologies to allow for embolization of aneurysms which are prone to unfavorable outcomes from an endovascular perspective [7,19]. However, Y-SACE is associated with a number of shortcomings directly related to the technique of placing two partially overlapping stents to reconstruct the neck and branch vessels of a WNBA. The relatively high metal-to-artery ratio at the intersection of the two stents promotes the conversion of laminar blood flow to turbulent flow, thereby increasing the predisposition to thromboembolic phenomena [3,5]. In the case of bifurcation aneurysms, thromboembolic complications are especially deleterious, as the respective perforator vessels of each bifurcation frequently supply eloquent brain areas, such as the thalamus by basilar bifurcation perforators. Medium− and large-sized WNBAs often incorporate one or both branch vessel...

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“…The ideal device for endovascular treatment of bifurcation aneurysms would have minimal or no metal implanted within the afferent or efferent vessels. Such devices include abandoned (13) and new (3,10) intra-aneurysmal devices designed to remodel the aneurysm neck. Because these devices are not presently US Food and Drug Administration approved for use, stent and balloon remodeling with coil embolization will continue to be the standard of care for endovascular treatment of bifurcation aneurysms.…”

mentioning

confidence: 99%