Vascular thrombosis induced by direct electric current

Piton, J; Billerey, J.; Am, Renou; Constant, P.; Jm, Caillé

doi:10.1007/bf00395312

Cited by 5 publications

(4 citation statements)

References 11 publications

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“…In their first clinical experience with this strategy, Guglielmi et al achieved partial or complete aneurysm occlusion in all patients with only one instance of transient neurologic deficit ( 21 ). At the time, the prevailing hypothesis was that intra-aneurysmal occlusion was achieved via electrothrombosis of negatively charged white blood cells, red blood cells, and blood products with application of a positively charged coil promoting clot formation ( 22 , 23 ). Later study would confirm that the therapeutic benefit of coiling was achieved due to the space-filling of coils as platinum coils with non-electrolytic detachment had similar rates of efficacy and recurrence ( 24 ).…”

Section: Endovascular Coilingmentioning

confidence: 99%

A review of technological innovations leading to modern endovascular brain aneurysm treatment

et al. 2023

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Section: Endovascular Coilingmentioning

confidence: 99%

A review of technological innovations leading to modern endovascular brain aneurysm treatment

et al. 2023

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“…Some of the underlying principles of current coil-occlusion techniques, based on surgical aneurysm exposure, had been described in detail by Mullan et Al 29 Piton et Al [30][31][32] had already developed fundamentals for an endovascular electrothrombotic treatment of intracranial vascular lesions, which never came to clinical practice at that time. After a latency period of more than a decade, the renaissance of electrothrombosis started with the publications of Guglielmi et Al 33,34 .…”

Section: Part Ii: In Vivo Experiments (Figure 3)mentioning

confidence: 99%

In vitro and in vivo Studies of the Extent of Electrothrombotic Deposition of Blood Elements on the Surface of Electrolytically Detachable Coils

Henkes

Brew

Felber³

et al. 2004

Interv Neuroradiol

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Endovascular treatment of intracranial aneurysms with electrolytically detachable coils is often claimed to be based on electrothrombosis, i.e. intra-aneurysmal thrombus formation through applied direct current. Despite the fact that this concept was described more than a century ago, the significance of electrothrombosis in the endovascular treatment of aneurysms remains debatable. Apart from electrothrombosis, mechanical obliteration of the aneurysmal lumen might be one of the many possible mechanisms to explain why and how detachable coils are effective in preventing aneurysms from (re-)rupture. The purpose of this experimental study was to investigate to what extent direct current comparable to that used for coil detachment would influence the adhesion of cellular and liquid blood components to the surface of electrolytically detachable platinum coils. For the in vitro study, electrolytically detachable platinum coils of various types were exposed to stagnant heparinised blood for a total of 16 h, without or with applied direct current for 30 or 90 s (1 mA, 4–6 V, coil as anode). For the in vivo study, electrolytically detachable platinum coils were exposed to flowing blood for 180 s, without or with applied direct current (2 mA, 4–6 V, coil as either anode or cathode), without anti-coagulation and after intravenous administration of 5000 U Heparin and again after the intravenous administration of 500 mg Aspisol in addition to Heparin. After exposure to blood according to these different experimental protocols, the coils were fixed in formalin solution, gold coated and examined by scanning electron microscopy. Thrombus formation on the surface of all unfibred coils was thin and highly variable both from coil to coil, and on different areas of any given coil. The application of direct current minimally enhanced thrombus formation in stagnant blood in vitro, but not in vivo. The cellular and fibrin adhesions on the coil surfaces without and with applied current did not effectively increase the diameter or volume of unfibred coils. Coils with attached nylon fibres, however, proved to be highly thrombogenic without or with application of current. In fibred coils, surface adhesions without and with applied current were voluminous enough to effectively increase the diameter of the coil, potentially important for the process of endosaccular aneurysm occlusion. Electrothrombosis plays no role in the endovascular treatment of intracranial aneurysms with electrolytically detachable coils. This explains why platinum coils with non-electrolytic detachment mechanisms show a similar efficiency and recurrence rate.

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“…The bases of this coil system had previously been described in the publications of Piton et Al (1978a,b, 1979 75,76,77, but many of the underlying principles had begun to be explored in the early 19 th century.…”

Section: Historical Overviewmentioning

confidence: 99%

“…On the basis of both experimentally study and clinical experience, it is known that a thrombus starts to form around the inserted needle within 5 minutes after insertion". The work of Piton et Al (1978a,b, 1979 75,76,77 already described all the essential elements of what would subsequently be called GDC. Platinum wires, among others, were employed to induce intravascular thrombosis.…”

mentioning

confidence: 99%

The Underlying Mechanisms of Endovascular Exclusion of Intracranial Aneurysms by Coils

Henkes

Brew

Miloslavski³

et al. 2003

Interv Neuroradiol

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Endovascular coil treatment of intracranial aneurysms is now widely accepted. We discuss some of the arguments for the relative roles of electrothrombosis, spontaneous thrombosis, mechanical filling, haemodynamic effects and surface properties in successful coil treatment. Despite an enormous body of literature, with many theories and much data, there is limited evidence for, or understanding of, the mechanisms by which coil treatment protects against aneurysm rupture. It seems likely that electrothrombosis plays no part. Dense packing is probably important in preventing recurrence. New technologies aiming to encourage endothelialisation and increased connective tissue formation appear promising.

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Vascular thrombosis induced by direct electric current

Cited by 5 publications

References 11 publications

A review of technological innovations leading to modern endovascular brain aneurysm treatment

A review of technological innovations leading to modern endovascular brain aneurysm treatment

In vitro and in vivo Studies of the Extent of Electrothrombotic Deposition of Blood Elements on the Surface of Electrolytically Detachable Coils

The Underlying Mechanisms of Endovascular Exclusion of Intracranial Aneurysms by Coils

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