Girdhar Gaurav, Li Junwei, Kostousov Larisa, Wainwright John, Chandler Wayne L
Venous Vascular R&D, Medtronic, 15 Hampshire St., Mansfield, MA, 02048, USA.
Neurovascular R&D, Medtronic, 9775 Toledo Way, Irvine, CA, 92618, USA.
J Thromb Thrombolysis. 2015 Nov;40(4):437-43. doi: 10.1007/s11239-015-1228-0.
Endoluminal devices such as metallic flow diversion (FD) and aneurysm bridging (AB) stents are used for treatment of intracranial aneurysms. Treatments are associated with thrombogenic events mandating the use of dual antiplatelet therapy in all cases. In the current in vitro study, we utilize a slow binding fluorogenic thrombin specific substrate to measure the thrombin generation potential of six devices: four FD devices (Pipeline™ Flex embolization device, Pipeline™ Flex embolization device with Shield Technology™, SILK+, FRED™) and two AB devices (Solitaire™ AB, LEO+). We show that the Pipeline™ Flex embolization device with Shield Technology™ has significantly lower peak thrombin and takes significantly longer time to achieve peak thrombin (time to peak) compared to the other three FD devices (p < 0.05), with statistically similar results to the less thrombogenic AB devices. We conclude that surface modification of endoluminal stents could be an effective method to mitigate thrombogenic complications.
诸如金属血流导向（FD）和动脉瘤桥接（AB）支架等腔内装置用于治疗颅内动脉瘤。这些治疗与血栓形成事件相关，因此在所有情况下都需要使用双重抗血小板治疗。在当前的体外研究中，我们使用一种缓慢结合的荧光凝血酶特异性底物来测量六种装置的凝血酶生成潜力：四种FD装置（Pipeline™ Flex栓塞装置、具有Shield Technology™的Pipeline™ Flex栓塞装置、SILK+、FRED™）和两种AB装置（Solitaire™ AB、LEO+）。我们发现，与其他三种FD装置相比，具有Shield Technology™的Pipeline™ Flex栓塞装置的凝血酶峰值显著更低，达到凝血酶峰值的时间（峰值时间）显著更长（p < 0.05），其结果与血栓形成性较低的AB装置在统计学上相似。我们得出结论，腔内支架的表面改性可能是减轻血栓形成并发症的有效方法。
