Aneurysm wall cellularity affects healing after coil embolization: assessment in a rat saccular aneurysm model.

Nevzati, Edin; Rey, Jeannine; Coluccia, Daniel; Grüter, Basil Erwin; Wanderer, Stefan; vonGunten, Michael; Remonda, Luca; Frosen, Juhana; Widmer, Hans Rudolf; Fandino, Javier; Marbacher, Serge (2020). Aneurysm wall cellularity affects healing after coil embolization: assessment in a rat saccular aneurysm model. Journal of neurointerventional surgery, 12(6), pp. 621-625. BMJ Publishing Group 10.1136/neurintsurg-2019-015335

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BACKGROUND AND PURPOSE

Despite significant technical advances, recanalization rates after endovascular therapy of ruptured intracranial aneurysms (IAs) remain a clinical challenge. A histopathological hallmark of ruptured human IA walls is mural cell loss. Mural smooth muscle cells (SMCs) are known to promote intraluminal healing in thrombosed experimental aneurysms. In this rat model we assess the natural history and healing process after coil embolization in SMC-rich and decellularized aneurysms.

METHODS

Saccular aneurysms were created by end-to-side anastomosis of an arterial graft from the descending thoracic aorta of a syngeneic donor rat to the infrarenal abdominal aorta of recipient male Wistar rats. Untreated arterial grafts were immediately transplanted, whereas aneurysms with loss of mural cells were chemically decellularized before implantation. Aneurysms underwent coil implantation during aneurysm anastomosis. Animals were randomly assigned either to the non-decellularized or decellularized group and underwent macroscopic and histological analyses on days 3, 7, 21, or 90 post-coil implantation.

RESULTS

A total of 55 rats underwent macroscopic and histologic analysis. After coil embolization, aneurysms with SMC-rich walls showed a linear course of thrombosis and neointima formation whereas decellularized aneurysms showed marked inflammatory wall degeneration with increased recanalization rates 21 days (p=0.002) and 90 days (p=0.037) later. The SMCs showed the ability to actively migrate into the intra-aneurysmal thrombus and participate in thrombus organization.

CONCLUSIONS

Coil embolization of aneurysms with highly degenerated walls is prone to further wall degeneration, increased inflammation, and recanalization compared with aneurysms with vital SMC-rich walls.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Neurosurgery

UniBE Contributor:

Widmer, Hans Rudolf

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1759-8486

Publisher:

BMJ Publishing Group

Language:

English

Submitter:

Nicole Söll

Date Deposited:

07 Jul 2020 14:37

Last Modified:

30 Jul 2020 20:41

Publisher DOI:

10.1136/neurintsurg-2019-015335

PubMed ID:

31871070

Uncontrolled Keywords:

aneurysm coil inflammation vessel wall

BORIS DOI:

10.7892/boris.145034

URI:

https://boris.unibe.ch/id/eprint/145034

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