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Karadeli HH, Kuram E. Single Component Polymers, Polymer Blends, and Polymer Composites for Interventional Endovascular Embolization of Intracranial Aneurysms. Macromol Biosci 2024; 24:e2300432. [PMID: 37992206 DOI: 10.1002/mabi.202300432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Revised: 11/03/2023] [Indexed: 11/24/2023]
Abstract
Intracranial aneurysm is the abnormal focal dilation in brain arteries. When untreated, it can enlarge to rupture points and account for subarachnoid hemorrhage cases. Intracranial aneurysms can be treated by blocking the flow of blood to the aneurysm sac with clipping of the aneurysm neck or endovascular embolization with embolics to promote the formation of the thrombus. Coils or an embolic device are inserted endovascularly into the aneurysm via a micro-catheter to fill the aneurysm. Many embolization materials have been developed. An embolization coil made of soft and thin platinum wire called the "Guglielmi detachable coil" (GDC) enables safer treatment for brain aneurysms. However, patients may experience aneurysm recurrence because of incomplete coil filling or compaction over time. Unsatisfactory recanalization rates and incomplete occlusion are the drawbacks of endovascular embolization. So, the fabrication of new medical devices with less invasive surgical techniques is mandatory to enhance the long-term therapeutic performance of existing endovascular procedures. For this aim, the current article reviews polymeric materials including blends and composites employed for embolization of intracranial aneurysms. Polymeric materials used in embolic agents, their advantages and challenges, results of the strategies used to overcome treatment, and results of clinical experiences are summarized and discussed.
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Affiliation(s)
- Hasan Hüseyin Karadeli
- Department of Neurology, Istanbul Medeniyet University Göztepe Prof. Dr. Süleyman Yalçın City Hospital, Istanbul, 34722, Turkey
| | - Emel Kuram
- Department of Mechanical Engineering, Gebze Technical University, Kocaeli, 41400, Turkey
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2
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Cayron AF, Morel S, Allémann E, Bijlenga P, Kwak BR. Imaging of intracranial aneurysms in animals: a systematic review of modalities. Neurosurg Rev 2023; 46:56. [PMID: 36786880 PMCID: PMC9928939 DOI: 10.1007/s10143-023-01953-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 11/28/2022] [Accepted: 01/23/2023] [Indexed: 02/15/2023]
Abstract
Intracranial aneurysm (IA) animal models are paramount to study IA pathophysiology and to test new endovascular treatments. A number of in vivo imaging modalities are available to characterize IAs at different stages of development in these animal models. This review describes existing in vivo imaging techniques used so far to visualize IAs in animal models. We systematically searched for studies containing in vivo imaging of induced IAs in animal models in PubMed and SPIE Digital library databases between 1 January 1945 and 13 July 2022. A total of 170 studies were retrieved and reviewed in detail, and information on the IA animal model, the objective of the study, and the imaging modality used was collected. A variety of methods to surgically construct or endogenously induce IAs in animals were identified, and 88% of the reviewed studies used surgical methods. The large majority of IA imaging in animals was performed for 4 reasons: basic research for IA models, testing of new IA treatment modalities, research on IA in vivo imaging of IAs, and research on IA pathophysiology. Six different imaging techniques were identified: conventional catheter angiography, computed tomography angiography, magnetic resonance angiography, hemodynamic imaging, optical coherence tomography, and fluorescence imaging. This review presents and discusses the advantages and disadvantages of all in vivo IA imaging techniques used in animal models to help future IA studies finding the most appropriate IA imaging modality and animal model to answer their research question.
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Affiliation(s)
- Anne F Cayron
- Department of Pathology and Immunology, Faculty of Medicine, University of Geneva, Rue Michel-Servet 1, CH-1211, Geneva, Switzerland
- Geneva Center for Inflammation Research, Faculty of Medicine, University of Geneva, Geneva, Switzerland
- School of Pharmaceutical Sciences, University of Geneva, Geneva, Switzerland
- Institute of Pharmaceutical Sciences of Western Switzerland, University of Geneva, Geneva, Switzerland
| | - Sandrine Morel
- Department of Pathology and Immunology, Faculty of Medicine, University of Geneva, Rue Michel-Servet 1, CH-1211, Geneva, Switzerland
- Geneva Center for Inflammation Research, Faculty of Medicine, University of Geneva, Geneva, Switzerland
- Department of Clinical Neurosciences - Division of Neurosurgery, Geneva University Hospitals and Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Eric Allémann
- School of Pharmaceutical Sciences, University of Geneva, Geneva, Switzerland
- Institute of Pharmaceutical Sciences of Western Switzerland, University of Geneva, Geneva, Switzerland
| | - Philippe Bijlenga
- Department of Clinical Neurosciences - Division of Neurosurgery, Geneva University Hospitals and Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Brenda R Kwak
- Department of Pathology and Immunology, Faculty of Medicine, University of Geneva, Rue Michel-Servet 1, CH-1211, Geneva, Switzerland.
- Geneva Center for Inflammation Research, Faculty of Medicine, University of Geneva, Geneva, Switzerland.
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Boillat G, Franssen T, Wanderer S, Rey J, Casoni D, Andereggen L, Marbacher S, Gruter BE. Anatomical Variations of the Common Carotid Arteries and Neck Structures of the New Zealand White Rabbit and Their Implications for the Development of Preclinical Extracranial Aneurysm Models. Brain Sci 2023; 13:brainsci13020222. [PMID: 36831765 PMCID: PMC9954206 DOI: 10.3390/brainsci13020222] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 01/20/2023] [Accepted: 01/25/2023] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND Rabbit models involving neck arteries are of growing importance for the development of preclinical aneurysm models. An optimal understanding of the anatomy is primordial to allow the conception of models while minimizing mortality and morbidity. The aim of this study is to give reliable anatomical landmarks to allow a standardized approach to the neck vessels. METHODS We performed a necropsy on nine specimens from ongoing experimental studies. We measured the distance between the origins of the right and left common carotid artery (rCCA/lCCA) and between the rCCA and the manubrium sterni (MS). The structures at risk were described. RESULTS Female New Zealand White rabbits (NZWR) weighing 3.7 ± 0.3 kg and aged 25 ± 5 weeks were included. The rCCA origin was located 9.6 ± 1.2 mm laterally and 10.1 ± 3.3 mm caudally to the MS. In all specimens, the lCCA originated from the aortic arch, together with the brachiocephalic trunk (BCT), and 6.2 ± 3.1 mm proximally to the rCCA origin. The external and internal jugular veins, trachea and laryngeal nerve were the main structures at risk. CONCLUSIONS The data help to localize both CCAs and their origin to guide surgical approaches with the manubrium sterni as a main landmark. Special attention has to be paid to the trachea, jugular veins and laryngeal nerves.
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Affiliation(s)
- Gwendoline Boillat
- Department of Neurosurgery, Kantonsspital Aarau, 5001 Aarau, Switzerland
- Cerebrovascular Research Group, Department for BioMedical Research, University of Bern, 3010 Bern, Switzerland
- Correspondence:
| | - Tim Franssen
- Cerebrovascular Research Group, Department for BioMedical Research, University of Bern, 3010 Bern, Switzerland
| | - Stefan Wanderer
- Department of Neurosurgery, Kantonsspital Aarau, 5001 Aarau, Switzerland
- Cerebrovascular Research Group, Department for BioMedical Research, University of Bern, 3010 Bern, Switzerland
| | - Jeannine Rey
- Department of Neurosurgery, Kantonsspital Aarau, 5001 Aarau, Switzerland
- Cerebrovascular Research Group, Department for BioMedical Research, University of Bern, 3010 Bern, Switzerland
| | - Daniela Casoni
- Experimental Surgery Facility, Department for Biomedical Research, Faculty of Medicine, University of Bern, 3010 Bern, Switzerland
| | - Lukas Andereggen
- Department of Neurosurgery, Kantonsspital Aarau, 5001 Aarau, Switzerland
- Cerebrovascular Research Group, Department for BioMedical Research, University of Bern, 3010 Bern, Switzerland
| | - Serge Marbacher
- Department of Neurosurgery, Kantonsspital Aarau, 5001 Aarau, Switzerland
- Cerebrovascular Research Group, Department for BioMedical Research, University of Bern, 3010 Bern, Switzerland
| | - Basil E. Gruter
- Department of Neurosurgery, Kantonsspital Aarau, 5001 Aarau, Switzerland
- Cerebrovascular Research Group, Department for BioMedical Research, University of Bern, 3010 Bern, Switzerland
- Institute of Neuroradiology, Department of Radiology, Kantonsspital Aarau, 5001 Aarau, Switzerland
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Tang H, Lu Z, Xue G, Li S, Xu F, Yan Y, Liu J, Zuo Q, Luo Y, Huang Q. The development and understanding of intracranial aneurysm based on rabbit model. Neuroradiology 2020; 62:1219-1230. [PMID: 32594185 DOI: 10.1007/s00234-020-02475-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Accepted: 06/10/2020] [Indexed: 10/24/2022]
Abstract
In modern society, intracranial aneurysms have seriously affected people's life. To better study and treat intracranial aneurysm, animal models are ideal candidates to perform biological research and preclinical endovascular device testing. Rabbit aneurysm model is one of the most commonly used animal models, and the rabbit aneurysms share similarities in histology, morphology, and hemodynamic aspects with human intracranial aneurysms, which is an ideal model for intracranial aneurysm pre-clinical and basic research. In this review, we will summarize the main methods of establishing rabbit aneurysms model and will further discuss the current biological mechanisms of intracranial aneurysms based on rabbit model. Further improvements of rabbit aneurysm model and more deep studies based on this model are needed to provide new insights into studying and clinical treating intracranial aneurysm.
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Affiliation(s)
- Haishuang Tang
- Department of Neurosurgery, Changhai Hospital, Second Military Medical University, Shanghai, 200433, People's Republic of China.,Naval Medical Center of PLA, Second Military Medical University, Shanghai, 200050, People's Republic of China
| | - Zhiwen Lu
- Department of Neurosurgery, Changhai Hospital, Second Military Medical University, Shanghai, 200433, People's Republic of China
| | - Gaici Xue
- Department of Neurosurgery, Changhai Hospital, Second Military Medical University, Shanghai, 200433, People's Republic of China
| | - Sisi Li
- Department of Neurosurgery, Changhai Hospital, Second Military Medical University, Shanghai, 200433, People's Republic of China
| | - Fengfeng Xu
- Naval Medical Center of PLA, Second Military Medical University, Shanghai, 200050, People's Republic of China
| | - Yazhou Yan
- Department of Neurosurgery, Changhai Hospital, Second Military Medical University, Shanghai, 200433, People's Republic of China
| | - Jianmin Liu
- Department of Neurosurgery, Changhai Hospital, Second Military Medical University, Shanghai, 200433, People's Republic of China
| | - Qiao Zuo
- Department of Neurosurgery, Changhai Hospital, Second Military Medical University, Shanghai, 200433, People's Republic of China
| | - Yin Luo
- Department of Neurosurgery, Changhai Hospital, Second Military Medical University, Shanghai, 200433, People's Republic of China
| | - Qinghai Huang
- Department of Neurosurgery, Changhai Hospital, Second Military Medical University, Shanghai, 200433, People's Republic of China.
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Herrmann AM, Meckel S, Gounis MJ, Kringe L, Motschall E, Mülling C, Boltze J. Large animals in neurointerventional research: A systematic review on models, techniques and their application in endovascular procedures for stroke, aneurysms and vascular malformations. J Cereb Blood Flow Metab 2019; 39:375-394. [PMID: 30732549 PMCID: PMC6421248 DOI: 10.1177/0271678x19827446] [Citation(s) in RCA: 54] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Neuroendovascular procedures have led to breakthroughs in the treatment of ischemic stroke, intracranial aneurysms, and intracranial arteriovenous malformations. Due to these substantial successes, there is continuous development of novel and refined therapeutic approaches. Large animal models feature various conceptual advantages in translational research, which makes them appealing for the development of novel endovascular treatments. However, the availability and role of large animal models have not been systematically described so far. Based on comprehensive research in two databases, this systematic review describes current large animal models in neuroendovascular research including their primary use. It may therefore serve as a compact compendium for researchers entering the field or looking for opportunities to refine study concepts. It also describes particular applications for ischemic stroke and aneurysm therapy, as well as for the treatment of arteriovenous malformations. It focuses on most promising study designs and readout parameters, as well as on important pitfalls in endovascular translational research including ways to circumvent them.
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Affiliation(s)
- Andrea M Herrmann
- 1 Department of Neuroradiology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.,2 Faculty of Veterinary Medicine, Institute of Veterinary Anatomy, Histology and Embryology, Leipzig University, Leipzig, Germany
| | - Stephan Meckel
- 1 Department of Neuroradiology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Matthew J Gounis
- 3 Department of Radiology, New England Center for Stroke Research, University of Massachusetts Medical School, Worcester, MA, USA
| | - Leona Kringe
- 1 Department of Neuroradiology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.,2 Faculty of Veterinary Medicine, Institute of Veterinary Anatomy, Histology and Embryology, Leipzig University, Leipzig, Germany
| | - Edith Motschall
- 4 Institute of Medical Biometry and Statistics, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany
| | - Christoph Mülling
- 2 Faculty of Veterinary Medicine, Institute of Veterinary Anatomy, Histology and Embryology, Leipzig University, Leipzig, Germany
| | - Johannes Boltze
- 5 School of Life Sciences, University of Warwick, UK.,6 Department of Translational Medicine and Cell Technology, Fraunhofer Research Institution for Marine Biotechnology and Cell Technology and Institute for Medical and Marine Biotechnology, University of Lübeck, Lübeck, Germany
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6
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Usami Y, Hirokawa N, Saitoh M, Okuda H, Someya M, Hasegawa T, Takakuwa Y, Sakata KI. Histopathological differences of experimental aneurysms treated with bare platinum, fibered, and bioactive coils. MINIM INVASIV THER 2018; 28:172-177. [PMID: 30113870 DOI: 10.1080/13645706.2018.1499532] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
PURPOSE To evaluate the histopathological features of experimental aneurysms embolized with bare platinum, fibered, and bioactive coils. MATERIAL AND METHODS Twelve experimental aneurysms were constructed in three swine. The aneurysms were divided into four groups and were embolized using a bare platinum coil alone (P group, n = 2), a bioactive coil alone (B group, n = 2), a combination of fibered and bare platinum coils (F/P group, n = 4) and a combination of fibered and bioactive coils (F/B group, n = 4). Histopathological data for all aneurysms recorded at 63 days were analyzed in terms of neointima formation, fibrosis, foreign-body giant-cell infiltration, and organization. RESULTS Fibrosis was significantly greater in group B compared with that in group F/P (p = .02). Inflammation with foreign-body giant-cell infiltration was significantly greater in groups F/P and F/B compared with that in groups P and B (p = .007). CONCLUSION The present study revealed that the embolic effect of fibered coils was not a thrombus but instead was a foreign-body response in the chronic phase.
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Affiliation(s)
- Yoko Usami
- a Department of Radiology , Sapporo Medical University , Sapporo , Japan
| | - Naoki Hirokawa
- a Department of Radiology , Sapporo Medical University , Sapporo , Japan
| | - Masato Saitoh
- a Department of Radiology , Sapporo Medical University , Sapporo , Japan
| | - Hiroki Okuda
- a Department of Radiology , Sapporo Medical University , Sapporo , Japan
| | - Masanori Someya
- a Department of Radiology , Sapporo Medical University , Sapporo , Japan
| | - Tadashi Hasegawa
- b Department of Surgical Pathology , Sapporo Medical University , Sapporo , Japan
| | - Yasunari Takakuwa
- c Department of Surgical Pathology , NTT-East Sapporo Hospital , Sapporo , Japan
| | - Koh-Ichi Sakata
- a Department of Radiology , Sapporo Medical University , Sapporo , Japan
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Marotta TR, Riina HA, McDougall I, Ricci DR, Killer-Oberpfalzer M. Physiological remodeling of bifurcation aneurysms: preclinical results of the eCLIPs device. J Neurosurg 2018; 128:475-481. [DOI: 10.3171/2016.10.jns162024] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVEIntracranial bifurcation aneurysms are complex lesions for which current therapy, including simple coiling, balloon- or stent-assisted coiling, coil retention, or intrasaccular devices, is inadequate. Thromboembolic complications due to a large burden of intraluminal metal, impedance of access to side branches, and a high recurrence rate, due largely to the unmitigated high-pressure flow into the aneurysm (water hammer effect), are among the limitations imposed by current therapy. The authors describe herein a novel device, eCLIPs, and its use in a preclinical laboratory study that suggests the device's design and functional features may overcome many of these limitations.METHODSA preclinical model of wide-necked bifurcation aneurysms in rabbits was used to assess functional features and efficacy of aneurysm occlusion by the eCLIPs device.RESULTSThe eCLIPs device, in bridging the aneurysm neck, allows coil retention, disrupts flow away from the aneurysm, leaves the main vessel and side branches unencumbered by intraluminal metal, and serves as a platform for endothelial growth across the neck, excluding the aneurysm from the circulation.CONCLUSIONSThe eCLIPs device permits physiological remodeling of the bifurcation.
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Affiliation(s)
- Thomas R. Marotta
- 1Department of Medical Imaging, University of Toronto
- 2Diagnostic and Therapeutic Neuroradiology, St. Michael's Hospital, University of Toronto, Ontario
| | - Howard A. Riina
- 3Department of Neurosurgery, NYU School of Medicine, NYU Langone Medical Center, New York, New York; and
| | | | - Donald R. Ricci
- 4Evasc Medical Systems Corp., Vancouver
- 5Division of Cardiology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Monika Killer-Oberpfalzer
- 6Department of Neurology/Neuroscience Institute, Christian Doppler Clinic, Paracelsus Medical University, Salzburg, Austria
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Wang S, Dai D, Kolumam Parameswaran P, Kadirvel R, Ding YH, Robertson AM, Kallmes DF. Rabbit aneurysm models mimic histologic wall types identified in human intracranial aneurysms. J Neurointerv Surg 2017; 10:411-415. [PMID: 28768819 PMCID: PMC5796872 DOI: 10.1136/neurintsurg-2017-013264] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2017] [Revised: 07/12/2017] [Accepted: 07/13/2017] [Indexed: 12/23/2022]
Abstract
Background Semiquantitative scales correlate histopathologic findings in the walls of human aneurysms with rupture status. Objective To apply a semiquantitative scale to the rabbit elastase-induced aneurysm model to determine whether rabbit histologic types mimic the full range of histologic subtypes of humans. Materials and methods Twenty-seven elastase-induced female rabbit aneurysms were studied, harvested at 2 weeks (n=5) and 12 weeks (n=22). Paraffin-embedded sections received hematoxylin-eosin and Verhoeff-Van Gieson staining. Immunohistochemistry was performed for α-smooth muscle actin and CD31 for endothelial cells. A semiquantitative scale was used for scoring based on human aneurysm tissue, divided into four subtypes according to cellular and extracellular matrix findings: type A, linear organized smooth muscle cells (SMCs) and intact endothelium; type B, thickened wall with disorganized, proliferating SMCs; type C, thick, collagenized and hypocellular wall with or without organizing thrombosis, and type D, extremely thin, hypocellular wall. Separate scoring was performed of the aneurysm neck and proximal and distal zones. Results Findings compatible with all subtypes of human aneurysm tissue were identified. Types A and C were found in 13 (48%) and 11 (41%) of 27 aneurysms and in the proximal and distal wall at both time points. Type B was found in 16 aneurysms (59%), exclusively at the neck at both time points; type D, in 14 aneurysms (52%), exclusively at proximal and distal zones of 12-week aneurysms. Conclusions The wall of elastase-induced rabbit aneurysm demonstrates histologic findings similar to the four categories of human cerebral aneurysms based on cellular and extracellular wall content.
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Affiliation(s)
- Shunli Wang
- Department of Radiology, Mayo Clinic, Rochester, Minnesota, USA.,Department of Pathology, Shanghai East Hospital, Tongji University, Shanghai, China
| | - Daying Dai
- Department of Radiology, Mayo Clinic, Rochester, Minnesota, USA
| | | | | | - Yong-Hong Ding
- Department of Radiology, Mayo Clinic, Rochester, Minnesota, USA
| | - Anne M Robertson
- Center for Biological Imaging, University of Pittsburgh, Pittsburgh, USA
| | - David F Kallmes
- Department of Radiology, Mayo Clinic, Rochester, Minnesota, USA
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Brinjikji W, Ding YH, Kallmes DF, Kadirvel R. From bench to bedside: utility of the rabbit elastase aneurysm model in preclinical studies of intracranial aneurysm treatment. J Neurointerv Surg 2016; 8:521-5. [PMID: 25904642 PMCID: PMC4932861 DOI: 10.1136/neurintsurg-2015-011704] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2015] [Accepted: 04/06/2015] [Indexed: 11/03/2022]
Abstract
Preclinical studies are important in helping practitioners and device developers improve techniques and tools for endovascular treatment of intracranial aneurysms. Thus an understanding of the major animal models used in such studies is important. The New Zealand rabbit elastase induced arterial aneurysm of the common carotid artery is one of the most commonly used models in testing the safety and efficacy of new endovascular devices. In this review we discuss: (1) the various techniques used to create the aneurysm, (2) complications of aneurysm creation, (3) natural history of the arterial aneurysm, (4) histopathologic and hemodynamic features of the aneurysm, (5) devices tested using this model, and (6) weaknesses of the model. We demonstrate how preclinical studies using this model are applied in the treatment of intracranial aneurysms in humans. The model has similar hemodynamic, morphological, and histologic characteristics to human aneurysms, and demonstrates similar healing responses to coiling as human aneurysms. Despite these strengths, however, the model does have many weaknesses, including the fact that the model does not emulate the complex inflammatory processes affecting growing and ruptured aneurysms. Furthermore, the extracranial location of the model affects its ability to be used in preclinical safety assessments of new devices. We conclude that the rabbit elastase model has characteristics that make it a simple and effective model for preclinical studies on the endovascular treatment of intracranial aneurysms, but further work is needed to develop aneurysm models that simulate the histopathologic and morphologic characteristics of growing and ruptured aneurysms.
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Affiliation(s)
| | - Yong H Ding
- Department of Radiology, Mayo Clinic, Rochester, Minnesota, USA
| | - David F Kallmes
- Department of Radiology, Mayo Clinic, Rochester, Minnesota, USA
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Papagiannaki C, Clarençon F, Ponsonnard S, Couquet C, Maizeroi-Eugène F, Bresson D, Yardin C, Mounayer C. Development of an angiogenesis animal model featuring brain arteriovenous malformation histological characteristics. J Neurointerv Surg 2016; 9:204-210. [PMID: 27013231 DOI: 10.1136/neurintsurg-2015-012173] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2015] [Revised: 02/28/2016] [Accepted: 03/01/2016] [Indexed: 11/03/2022]
Abstract
BACKGROUND Angiogenesis has a key role in the formation and evolution of brain arteriovenous malformations (AVMs). Numerous models have been developed aiming to recreate configuration of brain AVMs. OBJECTIVE To develop an animal model sharing the same pathological characteristics as human brain AVMs. MATERIALS AND METHODS Ten pigs were divided into two groups. Five animals underwent endovascular left common carotid artery (CCA) and external carotid artery (ECA) occlusion and five animals served as controls. DSA, associated with 3D-rotational angiography, was performed at day 0 and at 3 months in both groups. The volume of the retia was calculated. Vascular endothelial growth factor (VEGF)-A serum levels were measured in both groups at the same time intervals. Finally, the animals were sacrificed at 3 months and the retia were harvested for pathological and immunohistochemistry examinations. RESULTS At 3 months, a significantly higher rete volume was seen in group A than in group B (2.92±0.33 mL vs 1.87±0.69 mL, respectively; p=0.016). There was a trend for increased VEGF-A levels in group A at 3 months. In the occlusion group, histological findings showed significant reduction of media thickness and disrupted internal elastic lamina; immunohistochemistry findings showed strong reactivity for VEGF receptors and interleukin 6. CONCLUSIONS Unilateral endovascular occlusion of the CCA-ECA results in angiogenesis triggering of the rete mirabile with both significant augmentation of the rete volume and histological evidence of pro-angiogenic stimulation.
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Affiliation(s)
- Chrysanthi Papagiannaki
- ERMA (Equipe de Recherche Medicale Appliquée), Limoges University Hospital, Limoges, France.,Interventional Neuroradiology Department, Rouen University Hospital, Rouen, France
| | - Frédéric Clarençon
- ERMA (Equipe de Recherche Medicale Appliquée), Limoges University Hospital, Limoges, France.,Interventional Neuroradiology Department, Pitié-Salpêtrière Hospital, Paris, France
| | - Sébastien Ponsonnard
- ERMA (Equipe de Recherche Medicale Appliquée), Limoges University Hospital, Limoges, France.,Anesthesiology Department, Limoges University Hospital, Limoges, France
| | - Claude Couquet
- Haute Vienne Departmental Laboratory for Research and Analysis, Limoges, France
| | | | - Damien Bresson
- Department of Neurosurgery, Lariboisière University Hospital, Paris, France
| | - Catherine Yardin
- ERMA (Equipe de Recherche Medicale Appliquée), Limoges University Hospital, Limoges, France.,Department of Histology, Cytology, Cellular Biology and Cytogenetics, Limoges University Hospital, Limoges, France
| | - Charbel Mounayer
- ERMA (Equipe de Recherche Medicale Appliquée), Limoges University Hospital, Limoges, France.,Department of Interventional Neuroradiology, Limoges University Hospital, Limoges, France
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11
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Ding YH, Dai D, Schroeder D, Kadirvel R, Kallmes DF. Experimental testing of the dual-layer Woven EndoBridge device using an elastase-induced aneurysm model in rabbits. Interv Neuroradiol 2016; 22:299-303. [PMID: 26847799 DOI: 10.1177/1591019916628202] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2015] [Accepted: 01/01/2016] [Indexed: 11/17/2022] Open
Abstract
The dual-layer Woven EndoBridge (WEB) device (WEB II) is designed to improve the performance of the first-generation WEB device. This study was performed to evaluate the acute and chronic performance of WEB II for aneurysm occlusion in an elastase-induced aneurysm model in rabbits. We implanted WEB II devices in 36 elastase-induced aneurysms and followed up for one, three, six, and 12 months. Degree of aneurysm occlusion at follow-up was graded on the Web Occlusion Scale (WOS): Grade A, complete aneurysm occlusion; Grade B, complete occlusion with recess filling; Grade C, residual neck filling; and Grade D, residual aneurysm filling. Hematoxylin and eosin staining was performed for histological assessment of aneurysm healing. Grades A, B, C, and D aneurysm occlusion at one-month follow-up were noted in three (17%), three (17%), eight (44%), and four (22%) of 18 cases, respectively. At the three-month time point Grades A, B, C, and D were shown in two (33%), two (33%), one (17%), and one (17%) aneurysms. Six months after treatment, one (17%), two (33%), two (33%), and one (17%) cases demonstrated Grades A, B, C, and D occlusion. At the 12-month time point, Grades B, C, and D were shown in three (50%), two (33%), and one (17%) aneurysms. Histologic evaluation showed progressive thrombus organization within aneurysm lumen from one to 12 months. These results indicated that the WEB II device can achieve high rates of aneurysm occlusion over time in experimental aneurysms.
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Affiliation(s)
- Yong-Hong Ding
- Neuroradiology Research Laboratory, Department of Radiology, Mayo Clinic, USA
| | - Daying Dai
- Neuroradiology Research Laboratory, Department of Radiology, Mayo Clinic, USA
| | - Dana Schroeder
- Neuroradiology Research Laboratory, Department of Radiology, Mayo Clinic, USA
| | - Ramanathan Kadirvel
- Neuroradiology Research Laboratory, Department of Radiology, Mayo Clinic, USA
| | - David F Kallmes
- Neuroradiology Research Laboratory, Department of Radiology, Mayo Clinic, USA
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Wang Q, Qian K, Liu S, Yang Y, Liang B, Zheng C, Yang X, Xu H, Shen AQ. X-ray Visible and Uniform Alginate Microspheres Loaded with in Situ Synthesized BaSO4 Nanoparticles for in Vivo Transcatheter Arterial Embolization. Biomacromolecules 2015; 16:1240-6. [PMID: 25728288 DOI: 10.1021/acs.biomac.5b00027] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
| | - Kun Qian
- Department
of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | | | | | - Bin Liang
- Department
of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Chuansheng Zheng
- Department
of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | | | | | - Amy Q. Shen
- Micro/Bio/Nanofluidics
Unit, Okinawa Institute of Science and Technology Graduate University,
Japan, Mechanical Engineering, University of Washington, Seattle 98195, United States
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Monitoring of the heparinization in the rabbit animal model during endovascular interventions. Neuroradiology 2013; 55:883-8. [PMID: 23619701 DOI: 10.1007/s00234-013-1189-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2013] [Accepted: 04/08/2013] [Indexed: 10/26/2022]
Abstract
INTRODUCTION The purpose of this study was to monitor and to optimize heparinization during endovascular procedures in the New Zealand White Rabbit (NZWR) model. METHODS Right common carotid artery aneurysms were surgically created in 43 NZWR, with an average weight of 4,330 g (range 3,500-5,430 g). The activated partial thromboplastin time (aPTT) was measured during different stages of the interventional procedures. Blood samples were taken before and 10 min after administration of heparin and at the end of each endovascular procedure. We compared three different experimental groups: 100 U heparin, 500 U heparin and 100 U heparin plus pretreatment with aspirin and clopidogrel. The individual aPTT values were measured using a ball coagulometer. RESULTS The average baseline aPTT in the rabbit is 75.2 ± 18.9 s compared to a mean of 33 s (range 26-40 s) in humans. The dosages of heparin used achieved anticoagulation in all cases. Five hundred units of heparin increased the aPTT significantly more than 100 U. No difference was found between the aPTT obtained from the 100 U and the 100 U plus pretreatment group, as aspirin and clopidogrel do not affect the coagulation cascade. CONCLUSION One hundred units of heparin can achieve anticoagulation in a similar magnitude as needed in interventional procedures in humans. This fact enhances suitability of the rabbit animal model for the testing of intravascular devices.
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Ding YH, Tieu T, Kallmes DF. Creation of sidewall aneurysm in rabbits: aneurysm patency and growth follow-up. J Neurointerv Surg 2012; 6:29-31. [PMID: 23256990 DOI: 10.1136/neurintsurg-2012-010575] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
INTRODUCTION To explore the patency and growth of surgical sidewall aneurysms in rabbits. MATERIALS AND METHODS Forty sidewall aneurysms were created in the right common carotid artery (RCCA). Intravenous digital subtraction angiography (DSA) through the ear vein was performed immediately after creation. Three weeks later, intra-arterial DSA through the femoral artery was performed. Aneurysm sizes (neck, width, height and volume) were measured and calculated immediately after creation and 3 weeks later. Aneurysm patency after creation was evaluated. Differences in aneurysm sizes immediately after creation and 3 weeks later were compared using the Student's t test. RESULTS Aneurysms and the parent artery remained patent in 38 (95%) of the 40 rabbits 3 weeks after creation. Two other rabbits (5%) showed aneurysm occlusion. There was a significant difference in aneurysm neck size 3 weeks after creation (3.6±0.9 mm vs 2.4±0.4 mm, p<0.0001). The aneurysm became wider 3 weeks later (5.8±1.5 mm vs 4.3±1.2 mm, p<0.0001). Aneurysm length was also larger than immediately after creation (6.1±1.3 mm vs 4.3±1.4 mm, p<0.0001). The aneurysm volume was larger than that created immediately (127.5±89.4 mm(3) vs 51.0±34.9 mm(3), p<0.0001). CONCLUSIONS The patency rate of sidewall aneurysms in rabbits is high. The aneurysm keeps growing for at least 3 weeks after creation.
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Affiliation(s)
- Yong Hong Ding
- Department of Radiology, Neuroradiology Research Laboratory, Mayo Clinic, Rochester, Minnesota, USA
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Ding YH, Kadirvel R, Dai D, Kallmes DF. Creation of bifurcation-type elastase-induced aneurysms in rabbits. AJNR Am J Neuroradiol 2011; 34:E19-21. [PMID: 21903910 DOI: 10.3174/ajnr.a2666] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
SUMMARY Elastase incubation was performed in the LCCA in 13 New Zealand white rabbits. Three weeks after incubation, DSA demonstrated that 10 (10/13, 77%) bifurcation-type aneurysms at the origin of the LCCA were present; mean aneurysm neck, width, and height values were 3.7 ± 1.1, 3.8 ± 0.9, and 8.7 ± 2.3 mm, respectively. The LCCA can be used to create bifurcation aneurysms in rabbits.
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Affiliation(s)
- Y H Ding
- Neuroradiology Research Laboratory, Department of Radiology, Mayo Clinic, Rochester, Minnesota 55905, USA
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Ding YH, Lewis DA, Kadirvel R, Dai D, Kallmes DF. The Woven EndoBridge: a new aneurysm occlusion device. AJNR Am J Neuroradiol 2011; 32:607-11. [PMID: 21330397 DOI: 10.3174/ajnr.a2399] [Citation(s) in RCA: 123] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE The WEB device is an intrasaccular ellipsoid braided-wire embolization device designed to provide flow disruption along the aneurysm neck. The purpose of this study was to evaluate, in an in vivo aneurysm model, the acute and chronic performance of the WEB device regarding immediacy, degree, and durability of aneurysm occlusion. MATERIALS AND METHODS The WEB device was implanted in 24 elastase-induced aneurysms in New Zealand white rabbits and followed for 1, 3, 6, and 12 months (n = 6 at all time points). Degree of intra-aneurysmal flow disruption was graded on a 4-point scale based on DSA within 10 minutes following device implantation. Chronic aneurysm occlusion was rated by using a 3-point scale. All aneurysms were harvested for histologic analysis. RESULTS Immediate postimplant grade 1 (complete flow cessation) was noted in 7 (29%) of 24 cases. Grade 2 (near-complete flow cessation) was noted in 13 (54%) of 24 cases. At follow-up, complete occlusion was noted in 8 (33%) of 24 cases. Near-complete aneurysm occlusion was noted in 14 (58%) of 24 cases, while incomplete occlusion was noted in 2 (8%) cases. Stable aneurysm occlusion was present in 7 (29%) of 24 cases; progressive occlusion, in 14 (58%); and recanalization, in 3 (13%) cases. Histologic findings included aneurysm cavities filled with organized thrombus with connective tissue across the aneurysm neck. CONCLUSIONS The WEB device in experimental aneurysms demonstrated promising rates of immediate and long-term aneurysm occlusion.
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Affiliation(s)
- Y H Ding
- Neuroradiology Research Laboratory, Department of Radiology, Mayo Clinic, Rochester, Minnesota, USA
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Ding Y, Dai D, Kadirvel R, Lewis DA, Kallmes DF. Creation of large elastase-induced aneurysms: presurgical arterial remodeling using arteriovenous fistulas. AJNR Am J Neuroradiol 2010; 31:1935-7. [PMID: 20634302 DOI: 10.3174/ajnr.a2205] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE The size of elastase-induced aneurysms created in the usual way is relatively small. Our aim was to determine whether creation of a carotid-jugular AVF to induce remodeling of the RCCA results in larger elastase-induced aneurysms in rabbits. MATERIALS AND METHODS RCCA right-jugular AVFs were created in 6 New Zealand white rabbits (group 1), followed by elastase-induced aneurysm creation 4 weeks later. Follow-up DSA was performed to assess AVF patency and aneurysm sizes. Six other elastase-induced aneurysms created in the usual way were used as controls (group 2). The diameters of the RCCA and LCCA in group 1 and aneurysm sizes in both groups were measured from DSA images and compared by using the Student t test. RESULTS The patency of AVFs in group 1 was confirmed in all 6 (100%) cases. The mean RCCA diameter in group 1 was larger than that in the contralateral LCCA (3.6 ± 0.7 mm versus 2.0 ± 0.1 mm, range, 1.8-2.2 mm, P < .01). The mean aneurysm neck diameter, width, and height for group 1 was larger than those of group 2 (4.6 ± 0.9 mm versus 3.5 ± 0.7 mm, P < .05; 4.7 ± 1.1 mm versus 3.4 ± 0.5 mm, P < .05; 13.8 ± 3.2 mm versus 8.1 ± 1.3 mm, P < .05, respectively). Aneurysm volume for group 1 was significantly larger than that of group 2 (273 ± 172 mm³ versus 77 ± 32 mm³, P < .05). CONCLUSIONS Carotid-jugular AVFs result in RCCA remodeling that yields relatively larger elastase-induced aneurysms.
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Affiliation(s)
- Y Ding
- Department of Radiology, Mayo Clinic, Rochester, Minnesota 55905, USA
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MR imaging of hydrogel filament embolic devices loaded with superparamagnetic iron oxide or gadolinium. Neuroradiology 2010; 53:449-56. [DOI: 10.1007/s00234-010-0744-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2010] [Accepted: 06/28/2010] [Indexed: 10/19/2022]
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Angiographic and artefact-free computed tomography imaging of experimental aneurysms embolised with hydrogel filaments. Eur Radiol 2009; 20:870-6. [DOI: 10.1007/s00330-009-1604-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2009] [Revised: 08/13/2009] [Accepted: 08/21/2009] [Indexed: 10/20/2022]
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