Experimental testing of the dual-layer Woven EndoBridge device using an elastase-induced aneurysm model in rabbits

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.

Keywords

Aneurysm animal model device

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References

Brilstra

Rinkel

Graaf

. Treatment of intracranial aneurysms by embolization with coils: A systematic review. Stroke 1999; 30: 470–476.

Piotin

Blanc

Spelle

. Stent-assisted coiling of intracranial aneurysms: Clinical and angiographic results in 216 consecutive aneurysms. Stroke 2010; 41: 110–115.

Lubicz

Collignon

Raphaeli

. Flow-diverter stent for the endovascular treatment of intracranial aneurysms: A prospective study in 29 patients with 34 aneurysms. Stroke 2010; 41: 2247–2253.

Ding

Lewis

Kadirvel

. The Woven EndoBridge: A new aneurysm occlusion device. AJNR Am J Neuroradiol 2011; 32: 607–611.

Kallmes

Fujiwara

. New expandable hydrogel-platinum coil hybrid device for aneurysm embolization. AJNR Am J Neuroradiol 2002; 23: 1580–1588.

Kallmes

Ding

Dai

. A new endoluminal, flow-disrupting device for treatment of saccular aneurysms. Stroke 2007; 38: 2346–2352.

Dai

Ding

Danielson

. Endovascular treatment of experimental aneurysms by use of fibroblast-coated platinum coils: Angiographic and histopathological study. Stroke 2007; 38: 170–176.

Hans

Krings

Möller-Hartmann

. Endovascular treatment of experimentally induced aneurysms in rabbits using stents: A feasibility study. Neuroradiology 2003; 45: 430–434.

Killer

Kallmes

McCoy

. Angiographic and histologic comparison of experimental aneurysms embolized with Hydrogel filaments. AJNR Am J Neuroradiol 2009; 30: 1488–1495.

10.

Ding

Dai

Lewis

. Angiographic and histologic analysis of experimental aneurysms embolized with platinum coils, Matrix and HydroCoil. AJNR Am J Neuroradiol 2005; 26: 1757–1763.

11.

Kallmes

Ding

Dai

. A second-generation, endoluminal, flow-disrupting device for treatment of saccular aneurysms. AJNR Am J Neuroradiol 2009; 30: 1153–1158.

12.

Klisch

Sychra

Strasilla

. The Woven EndoBridge cerebral aneurysm embolization device (WEB II): Initial clinical experience. Neuroradiology 2011; 53: 599–607.

13.

Lubicz

Mine

Collignon

. WEB device for endovascular treatment of wide-neck bifurcation aneurysms. AJNR Am J Neuroradiol 2013; 34: 1209–1214.

14.

Pierot

Liebig

Sychra

. Intrasaccular flow-disruption treatment of intracranial aneurysms: Preliminary results of a multicenter clinical study. AJNR Am J Neuroradiol 2012; 33: 1232–1238.

15.

Wanke

Doerfler

Schoch

. Treatment of wide-necked intracranial aneurysms with a self-expanding stent system: Initial clinical experience. AJNR Am J Neuroradiol 2003; 24: 1192–1199.

16.

Altes

Cloft

Short

. 1999 ARRS Executive Council Award. Creation of saccular aneurysms in the rabbit: A model suitable for testing endovascular devices. American Roentgen Ray Society. AJR Am J Roentgenol 2000; 174: 349–354.

17.

Fujiwara

Cloft

Marx

. Serial angiography in an elastase-induced aneurysm model in rabbits: Evidence for progressive aneurysm enlargement after creation. AJNR Am J Neuroradiol 2001; 22: 698–703.

18.

Fiorella

Arthur

Byrne

. Interobserver variability in the assessment of aneurysm occlusion with the WEB aneurysm embolization system. J Neurointervent Surg 2015; 7: 591–595.

19.

Papagiannaki

Spelle

Januel

. WEB intrasaccular flow disruptor—prospective, multicenter experience in 83 patients with 85 aneurysms. AJNR Am J Neuroradiol 2014; 35: 2106–2111.

20.

Caroff

Mihalea

Klisch

. Single-layer WEBs: Intrasaccular flow disrupters for aneurysm treatment—feasibility results from a European study. AJNR Am J Neuroradiol 2015; 36: 1942–1946.

21.

Sivan-Hoffmann

Gory

Riva

. One-year angiographic follow-up after WEB-SL endovascular treatment of wide-neck bifurcation intracranial aneurysms. AJNR Am J Neuroradiol 2015; 36: 2320–2324.

22.

Cognard

Januel

. Remnants and recurrences after the use of the WEB intrasaccular device in large-neck bifurcation aneurysms. Neurosurgery 2015; 76: 522–530.