A Second-Generation, Endoluminal, Flow-Disrupting Device for Treatment of Saccular Aneurysms

被引:169
作者
Kallmes, D. F. [1 ]
Ding, Y. H. [1 ]
Dai, D. [1 ]
Kadirvel, R. [1 ]
Lewis, D. A. [1 ]
Cloft, H. J. [1 ]
机构
[1] Mayo Clin, Dept Radiol, Rochester, MN 55905 USA
关键词
MIDTERM FOLLOW-UP; INTRACRANIAL ANEURYSMS; ENDOVASCULAR TREATMENT; OCCLUSION HEAL; STENT; EXPERIENCE; MODEL; PLACEMENT; HYDROCOIL; COILS;
D O I
10.3174/ajnr.A1530
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
BACKGROUND AND PURPOSE: We report a preclinical study of a second-gene ration endoluminal device (Pipeline Embolization Device [PED-2] for aneurysmal occlusion and compare the PED-2 with its first-generation predecessor (PED-1). MATERIALS AND METHODS: Our Institutional Animal Care and Use Committee approved all studies. The PED-2 is a braided endoluminal, flow-diverting device and was implanted across the necks of 18 elastase-induced aneurysms in New Zealand white rabbits and followed for 1 month (n = 6), 3 months in = 6), and 6 months (n = 6). A second PED-2 was implanted in the abdominal aorta to cover the origins of the lumbar arteries. Angiographic occlusion rates were documented as complete, near-complete, and incomplete. Parent artery percent diameter stenosis was calculated. Results were compared with a previous publication focused on the PED-1, with use of the same model. We compared ordinal outcomes using Fisher Exact or chi(2) tests. We compared continuous data using analysis of variance. RESULTS: Occlusion rates (complete and incomplete) for the PED-2 were noted in 17 cases (94%) and 1 (6%), respectively, compared with 9 cases of complete (53%) and 8 (47%) of incomplete occlusion with the PED-1 (P = .0072). No incidents of branch artery occlusion or distal emboli in vessels downstream of the parent artery were observed with the PED-2. Parent artery neointimal hyperplasia was minimal in most cases and was significantly less than in the PED-1. CONCLUSIONS: The PED-2 is a biocompatible and hemocompatible device that occludes saccular aneurysms while preserving the parent artery and small-branch vessels in our animal model.
引用
收藏
页码:1153 / 1158
页数:6
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