In vivo cerebral aneurysm models

Abstract

<jats:p>Cerebral aneurysm rupture is a devastating event resulting in subarachnoid hemorrhage and is associated with significant morbidity and death. Up to 50% of individuals do not survive aneurysm rupture, with the majority of survivors suffering some degree of neurological deficit. Therefore, prior to aneurysm rupture, a large number of diagnosed patients are treated either microsurgically via clipping or endovascularly to prevent aneurysm filling. With the advancement of endovascular surgical techniques and devices, endovascular treatment of cerebral aneurysms is becoming the first-line therapy at many hospitals. Despite this fact, a large number of endovascularly treated patients will have aneurysm recanalization and progression and will require retreatment. The lack of approved pharmacological interventions for cerebral aneurysms and the need for retreatment have led to a growing interest in understanding the molecular, cellular, and physiological determinants of cerebral aneurysm pathogenesis, maturation, and rupture. To this end, the use of animal cerebral aneurysm models has contributed significantly to our current understanding of cerebral aneurysm biology and to the development of and training in endovascular devices. This review summarizes the small and large animal models of cerebral aneurysm that are being used to explore the pathophysiology of cerebral aneurysms, as well as the development of novel endovascular devices for aneurysm treatment.</jats:p>

Letter to the Editor. The missing piece to solve the equation

“…In order to better understand the mechanisms of aneurysm formation and rupture, animal aneurysm models have been proposed. 9 However, we emphasize the importance of human aneurysm specimen. 10 Furthermore, we think that additional research is needed regarding patientspecific intravascular vessel wall imaging, and Gounis et al 3 have highlighted the capabilities of neurovascular OCT. Additionally, knowledge about the diseased aneurysm wall is increasingly gained via tissue extraction and extensive histological analysis.…”

Endothelialized silicone aneurysm models for in vitro evaluation of flow diverters

“…However, they typically lack relevant cellular and biological components. [5][6][7][8] The rabbit elastase-induced model is a wellestablished model for assessing neurovascular devices 4 19-21 and is biologically comprehensive with relevant geometries, [22][23][24] but the complex geometries may be difficult to control within and between animals. Additionally, advanced imaging, infrastructure, and animal facilities are required for in vivo device studies.…”

“…Benchtop models often use clinical or anatomically relevant data to produce 3D silicone replicas as a mechanism for device testing, physician training, and other clinical research. [5][6][7][8] These models can accurately capture complex geometries, but they typically lack cellular or biologic components. Recent work has documented the incorporation of cells in polydimethylsiloxane (PDMS) benchtop models, but these models were focused on hemodynamic and genetic studies and were not used for device testing.…”

Saccular Aneurysm Models Featuring Growth and Rupture: A Systematic Review

“…Increased understanding of the complex pathobiology of intracranial aneurysm (IA) growth, rupture, and the effects of endovascular therapy depends on epidemiological data analysis, clinical findings, histopathology of IA samples obtained during surgery, and gene linkage analysis [1][2][3][4][5] Experimental work using animal models of IA are needed to delineate the biological mechanisms of IA formation and growth, and to establish new medical and endovascular therapies and materials to prevent IA rupture. Cerebral aneurysm models can be divided into two large groups: Intra-and extracranial models [6].…”

“…This review focuses on a small subgroup of extracranial saccular aneurysm models that demonstrate growth and potential rupture during follow-up. It is likely that this subgroup of models will become more important for challenging the testing of devices prior to their clinical application [6,7,12]. This systematic review provides a comprehensive overview of available techniques and associated characteristics of extracranial aneurysm models featuring growth and rupture.…”