Patterns of Neointima Formation After Coil or Stent Treatment in a Rat Saccular Sidewall Aneurysm Model.

Grüter, Basil E.; Wanderer, Stefan; Strange, Fabio; Boillat, Gwendoline; Täschler, Dominik; Rey, Jeannine; Croci, Davide M; Grandgirard, Denis; Leib, Stephen; von Gunten, Michael; Di Santo, Stefano; Widmer, Hans Rudolf; Remonda, Luca; Andereggen, Lukas; Nevzati, Edin; Coluccia, Daniel; Fandino, Javier; Marbacher, Serge (2021). Patterns of Neointima Formation After Coil or Stent Treatment in a Rat Saccular Sidewall Aneurysm Model. Stroke, 52(3), pp. 1043-1052. American Heart Association 10.1161/STROKEAHA.120.032255

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BACKGROUND AND PURPOSE

Endovascular aneurysm treatment relies on a biological process, including cell migration for thrombus organization and growth of a neointima. To better understand aneurysm healing, our study explores the origin of neointima-forming and thrombus-organizing cells in a rat saccular sidewall aneurysm model.

METHODS

Saccular aneurysms were transplanted onto the abdominal aorta of male Lewis rats and endovascularly treated with coils (n=28) or stents (n=26). In 34 cases, GFP+ (green fluorescent protein)-expressing vital aneurysms were sutured on wild-type rats, and in 23 cases, decellularized wild-type aneurysms were sutured on GFP+ rats. Follow-up at 3, 7, 14, 21, and 28 days evaluated aneurysms by fluorescence angiography, macroscopic inspection, and microscopy for healing and inflammation status. Furthermore, the origin of cells was tracked with fluorescence histology.

RESULTS

In animals with successful functional healing, histological studies showed a gradually advancing thrombus organization over time characterized by progressively growing neointima from the periphery of the aneurysm toward the center. Cell counts revealed similar distributions of GFP+ cells for coil or stent treatment in the aneurysm wall (54.4% versus 48.7%) and inside the thrombus (20.5% versus 20.2%) but significantly more GFP+ cells in the neointima of coiled (27.2 %) than stented aneurysms (10.4%; P=0.008).

CONCLUSIONS

Neointima formation and thrombus organization are concurrent processes during aneurysm healing. Thrombus-organizing cells originate predominantly in the parent artery. Neointima formation relies more on cell migration from the aneurysm wall in coiled aneurysms but receives greater contributions from cells originating in the parent artery in stent-treated aneurysms. Cell migration, which allows for a continuous endothelial lining along the parent artery's lumen, may be a prerequisite for complete aneurysm healing after endovascular therapy. In terms of translation into clinical practice, these findings may explain the variability in achieving complete aneurysm healing after coil treatment and the improved healing rate in stent-assisted coiling.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Service Sector > Institute for Infectious Diseases > Research
04 Faculty of Medicine > Service Sector > Institute for Infectious Diseases
04 Faculty of Medicine > Pre-clinic Human Medicine > BioMedical Research (DBMR)
04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Neurosurgery
04 Faculty of Medicine > Pre-clinic Human Medicine > BioMedical Research (DBMR) > Forschungsbereich Mu50 > Forschungsgruppe Neurochirurgie

UniBE Contributor:

Wanderer, Stefan; Grandgirard, Denis; Leib, Stephen; Di Santo, Stefano; Widmer, Hans Rudolf; Remonda, Luca; Andereggen, Lukas; Fandino, Javier and Marbacher, Serge

Subjects:

600 Technology > 610 Medicine & health
500 Science > 570 Life sciences; biology

ISSN:

1524-4628

Publisher:

American Heart Association

Funders:

[4] Swiss National Science Foundation ; [UNSPECIFIED] Research Council, Kantonsspital Aarau, Aarau, Switzerland

Language:

English

Submitter:

Stephen Leib

Date Deposited:

16 Feb 2021 09:09

Last Modified:

24 Feb 2021 09:55

Publisher DOI:

10.1161/STROKEAHA.120.032255

PubMed ID:

33504186

Uncontrolled Keywords:

aneurysm microscopy models, animal neointima stents

BORIS DOI:

10.48350/151735

URI:

https://boris.unibe.ch/id/eprint/151735

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