Phosphorylcholine surface modified flow diverter associated with reduced intimal hyperplasia

Caroff, Jildaz; Tamura, Takamitsu; King, R; Lylyk, Pedro; Langan, Erin; Brooks, Olivia W.; Clarençon, Frédéric; Wainwright, J; Spelle, Laurent; Marosfői, M; Gounis, Matthew J.; Puri, Ajit S

doi:10.1136/neurintsurg-2018-013776

Cited by 33 publications

(19 citation statements)

References 29 publications

(19 reference statements)

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“…This finding suggests that PC surface modification results in similar rates of in-stent stenosis or late loss between PED Flex and Shield. However, Caroff et al reported that a surface-modified flow diverter had significantly less in-stent neointimal hyperplasia in a rabbit model 20. The difference in animal model might cause the difference between their result and ours.…”

Section: Discussioncontrasting

confidence: 60%

Preliminary outcomes of single antiplatelet therapy for surface-modified flow diverters in an animal model: analysis of neointimal development and thrombus formation using OCT

Matsuda

Jang²,

Chung³

et al. 2018

J NeuroIntervent Surg

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Section: Discussioncontrasting

confidence: 60%

Preliminary outcomes of single antiplatelet therapy for surface-modified flow diverters in an animal model: analysis of neointimal development and thrombus formation using OCT

Matsuda

Jang²,

Chung³

et al. 2018

J NeuroIntervent Surg

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“…11 The authors concluded that, in comparison with Pipeline Flex, Pipeline Shield results in earlier neointimal formation, resulting in reduced thrombosis, reduced late neointimal hyperplasia, and a reduced in-stent stenosis rate. Furthermore, a recent preclinical study has demonstrated reduced intimal hyperplasia without reducing aneurysm occlusion rates by using the Shield technology 17…”

Section: Discussionmentioning

confidence: 99%

Treatment of intracranial aneurysms using the pipeline flex embolization device with shield technology: angiographic and safety outcomes at 1-year follow-up

Martínez‐Galdámez

Lamin

Lagios

et al. 2018

J NeuroIntervent Surg

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PurposeThe Pipeline Embolization Device (PED) is a routine first-line treatment option for intracranial aneurysms (IAs). The Pipeline Flex Embolization Device with Shield Technology (Pipeline Shield) is an updated version of the PED which has been modified to include a surface phosphorylcholine biocompatible polymer. Its early technical success and safety have been reported previously. Here, we assessed the long-term safety and efficacy of the Pipeline Shield for the treatment of IAs.Materials and methodsThe Pipeline Flex Embolization Device with Shield Technology (PFLEX) study was a prospective, single-arm, multicenter study for the treatment of unruptured IAs using the Pipeline Shield. The primary endpoint was a major stroke in the territory supplied by the treated artery or neurologic death at 1-year post-procedure. Angiographic outcomes were also assessed by an independent radiology laboratory at 6 months and 1 year.ResultsFifty patients (mean age, 53 years; 82% female) with 50 unruptured IAs were treated. Mean aneurysm diameter was 8.82±6.15 mm. Of the target aneurysms, 38/50 (76%) were small (<10 mm), 11/50 (22%) were large (≥10 and<25 mm), and 1/50 (2%) was giant (≥25 mm). Forty-seven (94%) were located in the internal carotid artery and three (6%) in the vertebral artery. At 1-year post-procedure, no major strokes or neurologic deaths were reported, and complete occlusion was achieved in 27/33 (81.8%). There were no instances of aneurysm recurrence or retreatment.ConclusionsOur 1-year follow-up concerning angiographic and safety outcomes corroborate previous evidence that the Pipeline Shield is a safe and effective treatment for IAs.Trial registration numberNCT02390037

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“… 4 The PED Shield induces less neointimal hyperplasia in rabbit models at 30 days compared with the PED Classic (5.7% vs 8.9%; p<0.0001) based on OCT and histopathological findings (r 2 =0.83; p<0.0001). 10 The superior MCA branch in our patient was jailed and despite concerns for vessel occlusion, previous in vivo studies have demonstrated branches to remain patent despite a high surface tissue coverage 11 ; therefore, treating the patient with PED Shield suggests an added benefit in this patient’s case. …”

Section: Discussionmentioning

confidence: 61%

PED Flex with Shield Technology: a feasible alternative for fusiform MCA aneurysms

et al. 2018

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Phosphorylcholine surface modified flow diverter associated with reduced intimal hyperplasia

Abstract: OCT is a promising technique for immediate and long-term evaluation of flow diverter stent treatments. In an animal model, phosphorylcholine surface modified flow diverters induces less NIH after stent implant without reducing aneurysm occlusion rates.

Cited by 33 publications

References 29 publications

Preliminary outcomes of single antiplatelet therapy for surface-modified flow diverters in an animal model: analysis of neointimal development and thrombus formation using OCT

Preliminary outcomes of single antiplatelet therapy for surface-modified flow diverters in an animal model: analysis of neointimal development and thrombus formation using OCT

Treatment of intracranial aneurysms using the pipeline flex embolization device with shield technology: angiographic and safety outcomes at 1-year follow-up

PED Flex with Shield Technology: a feasible alternative for fusiform MCA aneurysms

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