The DERIVO 2heal embolisation device: A technical report using single antiplatelet therapy for intracranial pseudoaneurysm treatment

Goertz, Lukas; Schönfeld, Michael; Zopfs, David; Lüers, Jan-Christoffer; Schlamann, Marc; Kabbasch, Christoph

doi:10.1177/15910199221104620

Cited by 7 publications

(2 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…gov, NCT05543447), which will soon be enrolling patients. SAPT with this device appears promising, 68 but larger studies are needed to corroborate the preliminary data.…”

Section: Fibrin Nano-coating With Bound Heparinmentioning

confidence: 86%

Surface modification of neurovascular stents: from bench to patient

Zoppo,

Mocco,

Manning

et al. 2023

J NeuroIntervent Surg

View full text Add to dashboard Cite

Flow-diverting stents (FDs) for the treatment of cerebrovascular aneurysms are revolutionary. However, these devices require systemic dual antiplatelet therapy (DAPT) to reduce thromboembolic complications. Given the risk of ischemic complications as well as morbidity and contraindications associated with DAPT, demonstrating safety and efficacy for FDs either without DAPT or reducing the duration of DAPT is a priority. The former may be achieved by surface modifications that decrease device thrombogenicity, and the latter by using coatings that expedite endothelial growth. Biomimetics, commonly achieved by grafting hydrophilic and non-interacting polymers to surfaces, can mask the device surface with nature-derived coatings from circulating factors that normally activate coagulation and inflammation. One strategy is to mimic the surfaces of innocuous circulatory system components. Phosphorylcholine and glycan coatings are naturally inspired and present on the surface of all eukaryotic cell membranes. Another strategy involves linking synthetic biocompatible polymer brushes to the surface of a device that disrupts normal interaction with circulating proteins and cells. Finally, drug immobilization can also impart antithrombotic effects that counteract normal foreign body reactions in the circulatory system without systemic effects. Heparin coatings have been explored since the 1960s and used on a variety of blood contacting surfaces. This concept is now being explored for neurovascular devices. Coatings that improve endothelialization are not as clinically mature as anti-thrombogenic coatings. Coronary stents have used an anti-CD34 antibody coating to capture circulating endothelial progenitor cells on the surface, potentially accelerating endothelial integration. Similarly, coatings with CD31 analogs are being explored for neurovascular implants.

show abstract

“…gov, NCT05543447), which will soon be enrolling patients. SAPT with this device appears promising, 68 but larger studies are needed to corroborate the preliminary data.…”

Section: Fibrin Nano-coating With Bound Heparinmentioning

confidence: 86%

Surface modification of neurovascular stents: from bench to patient

Zoppo,

Mocco,

Manning

et al. 2023

J NeuroIntervent Surg

View full text Add to dashboard Cite

show abstract

“…A further milestone in FDS development was the introduction of anti-thrombotic coatings for flow diverter stents [41,42,43]. As discussed above, DAPT is generally required for 3 to 12 months after FDS implantation in order to prevent ischemic complications at the cost of increasing the risk for hemorrhage.…”

Section: Advancements In Flow Diversion Over the Past Decadementioning

confidence: 99%

Review: Flow Diversion for the Treatment of Middle Cerebral Artery Aneurysms

Schüngel,

Wohlgemuth,

Elolf

et al. 2024

Rofo

View full text Add to dashboard Cite

The invention of flow diverting stents (FDS) is a novel milestone in the field of endovascular aneurysm therapy, promoting physiological healing of the vessel segment contrary to prior deconstructive treatment strategies, such as coiling. The effects of FDS are based on changes in flow patterns, segmental wall stabilization, and the growth of a neointima. Although flow diversion is already well established for cerebral aneurysms in proximal segments, peripheral locations remain challenging. Especially the middle cerebral artery (MCA) with its predominance of non-collateralized perforators and functional end arteries that supply the eloquent areas of the brain is of major concern.The literature was reviewed for flow diversion of the MCA and antiplatelet therapy.Resulting from the special anatomical characteristics of the MCA, FDS implantation in this territory is completely different from the proximal vessel segments. Still, flow diversion represents an effective endovascular strategy, especially in otherwise non-accessible or sufficiently treatable lesions. However, the risk of ischemic adverse events might be increased. Special attention to the individual decision regarding device selection, antiplatelet regimen, and exact definition of the proximal and distal landing zone considering the jailed side branches is essential for a good angiographic and clinical outcome.

show abstract

A New Fibrin-Heparine Coated Self-Expanding Stent for the Rescue Treatment of Intracranial Stenosis—a Multicentric Study

Dorn,

Voss,

Zidan

et al. 2024

Clin Neuroradiol

View full text Add to dashboard Cite

Introduction Rescue intracranial stenting is necessary to provide sufficient recanalization after mechanical thrombectomy (MT) in patients with acute large vessel occlusions (LVO) due to an underlying intracranial atherosclerotic disease (ICAD). The CREDO heal is a novel stent that provides a potentially lower thrombogenicity due to surface modification. We present the first multicentric experience with the CREDO heal for acute rescue stenting. Methods Data of 81 patients who underwent rescue stenting after MT at 12 centers in Germany and Spain were prospectively collected and retrospectively evaluated. Results Final mTICI 2b‑3 was reached in 95.1% after median two MT maneuvers and stenting. Four periprocedural complications resulted in clinical deterioration (4.9%). Intraparenchymal hemorrhage occurred in one patient (1.2%) and functional independence at FU was reached by 42% of the patients. Most interventions were performed under Gp IIb/IIIa inhibitors. Conclusion CREDO heal was effective and safe in our case series. However, more data is needed to define the optimal antithrombotic regime. The use under single antiplatelet medication is not supported by our study.

show abstract

The DERIVO 2heal embolisation device: A technical report using single antiplatelet therapy for intracranial pseudoaneurysm treatment

Cited by 7 publications

References 18 publications

Surface modification of neurovascular stents: from bench to patient

Surface modification of neurovascular stents: from bench to patient

Review: Flow Diversion for the Treatment of Middle Cerebral Artery Aneurysms

A New Fibrin-Heparine Coated Self-Expanding Stent for the Rescue Treatment of Intracranial Stenosis—a Multicentric Study

Contact Info

Product

Resources

About