Endovascular Treatment of Experimental Aneurysms by Use of Fibroblast-Coated Platinum Coils

Abstract

Background and Purpose-The purpose of this study was to determine whether implanting exogenous fibroblasts on platinum coils could enhance intra-aneurysmal fibrosis. Hypotheses included: (1) fibroblast-coated (FBC) platinum coils can improve angiographic results after embolization; and (2) FBC platinum coils can accelerate histological healing of embolized aneurysms. Methods-Experimental aneurysms in rabbits were embolized with control platinum coils (nϭ18) or FBC coils (nϭ18).Subjects were euthanized at 14 days, 1 month, 3 months and 6 months after implantation. Digital subtraction angiography was used to evaluate stability after embolization. Histological samples were examined with a grading system (range, 0 to 12) based on neck and dome healing. Results-Histology total scores and fibrosis ratio at 14 days were significantly greater in the FBC coil group compared with controls (6.6Ϯ1.9 versus 2.5Ϯ1.1, 1.2Ϯ0.6% versus 0.2Ϯ0.3%, respectively; Pϭ0.0090). Cavities embolized with FBC coils showed cellular proliferation and thrombus organization, with an endothelialized membrane bridging the neck. There were no differences between groups in the later timepoints. The FBC coil group showed radiographic stability in 11 (61%) cases, coil compaction in 2 (11%) cases, and progressive occlusion in 5 (28%) cases. No progressive occlusion was seen in controls; 3 (17%) of 18 control cases exhibited coil compaction (Pϭ0.0546). Conclusions-FBC

The Woven EndoBridge: A New Aneurysm Occlusion Device

“…Unfortunately, it has yet to be proved in the clinical setting that most coil modifications perform better than bare platinum coils. [1][2][3][4][5][6][7][8][9][10] Intraluminal "flow diverters," comprising tubular braided metallic implants, have shown, in preclinical studies and in early clinical reports, the ability to achieve complete occlusion in a high proportion of aneurysms. [11][12][13][14][15][16][17][18][19][20] Excellent occlusion rates after flow-diverter therapy are seen even in large and giant aneurysms, which show recanalization rates of Ն50% after coil embolization.…”

Endovascular Treatment of Experimental Aneurysms with Use of Fibroblast Transfected with Replication-Deficient Adenovirus Containing Bone Morphogenetic Protein-13 Gene

“…13 However, we failed to demonstrate enhanced production of collagen; instead, cells were surrounded by loose extracellular matrix. Intra-aneurysmal synthesis of collagenous extracellular matrix is considered to be beneficial for permanent closure of aneurysmal cavities.…”

“…13 Recombinant type-5 human adenoviral vectors with complete deletion of the E1A and E1B regions and a partial deletion of the E3 region of the viral genome were used. The therapeutic vector was constructed with the BMP-13 gene under control of a cytomegalovirus promoter (Ad-BMP-13).…”

“…The results for platinum coil (PA) and fibroblast-coated platinum coils (FBC)-treated controls in the same model at the same time points have been reported previously. 13 Aneurysmal sizes (neck, width, and height), volume, and coil-packing attenuation in each group were calculated and compared with use of a 2-way analysis of variance (least squares test; JMP software, SAS Institute, Cary, NC). If an interaction (Group*Duration) was not found, then a main effects test on the group was performed.…”

“…The overall scores for the 20 cases included 1 (5%) case of progressive occlusion, 4 (20%) with coil compaction, and 15 (75%) with stable occlusion. Findings were compared with previously reported 13 historical controls for PAs and FBCs. Occurrences of coil compaction, stable occlusion, and progressive occlusion in these 3 groups are listed in Table 2.…”