Three-dimensional bioprinting of aneurysm-bearing tissue structure for endovascular deployment of embolization coils

Abstract

Various types of embolization devices have been developed for the treatment of cerebral aneurysms. However, it is challenging to properly evaluate device performance and train medical personnel for device deployment without the aid of functionally relevant models. Current in vitro aneurysm models suffer from a lack of key functional and morphological features of brain vasculature that limit their applicability for these purposes. These features include the physiologically relevant mechanical properties and the dynamic cellular environment of blood vessels subjected to constant fluid flow. Herein, we developed three-dimensionally (3D) printed aneurysm-bearing vascularized tissue structures using gelatin-fibrin hydrogel of which the inner vessel walls were seeded with human cerebral microvascular endothelial cells (hCMECs). The hCMECs readily exhibited cellular attachment, spreading, and confluency all around the vessel walls, including the aneurysm walls. Additionally, the in vitro platform was directly amenable to flow measurements via particle image velocimetry, enabling the direct assessment of the vascular flow dynamics for comparison to a 3D computational fluid dynamics model. Detachable coils were delivered into the printed aneurysm sac through the vessel using a microcatheter and static blood plasma clotting was monitored inside the aneurysm sac and around the coils. This biomimetic in vitro aneurysm model is a promising method for examining the biocompatibility and hemostatic efficiency of embolization devices and for providing hemodynamic information which would aid in predicting aneurysm rupture or healing response after treatment.

Postmarket American Experience With Woven EndoBridge Device: Adjudicated Multicenter Case Series

“…The challenge of matching device shape and size with a targeted aneurysm may be aided in the future by 3-dimensional modeling techniques. 9,10 Dual-antiplatelet use at the time of intervention was higher than in WEB-IT (85% v 69%). This may reflect operator uncertainty and may evolve with increased experience.…”

Microcatheter-guided compartment packing of acutely ruptured complex intracerebral aneurysms (ARCIAs): Preliminary experience and technical note

“…Difficulties in traversing the microcatheter through tortuous vasculature, guiding the microcatheter tip to the 1/2 or 2/3 position within the aneurysm, and maintaining it in a stable position account for many coil embolization procedures fail. These causes include incomplete aneurysm occlusion ( 16 , 31 , 32 ), aneurysm recanalization ( 31 ), coil misalignment ( 33 ), and intraoperative rupture ( 34 ). These failures can be attributed to unfavorable vessel tortuosity and CIAs geometry.…”

The Biofabrication of Diseased Artery In Vitro Models

“…Especially, as 3D bioprinting technology can prepare models of aneurysm lesions of different degrees, it provides a medical diagnostic technology for predicting aneurysms at different stages. Jang and teammates proposed the first-ever in vitro living 3D printed aneurysm with a fully encapsulated extracellular matrix interrogation therapy and intravascular device [175]. This in vitro aneurysm model could test the biocompatibility and hemostatic efficiency of the embolization device and provide hemodynamic information for predicting aneurysm rupture or healing response after treatment.…”