Ding Yong-Hong, Dai Daying, Schroeder Dana, Kadirvel Ramanathan, Kallmes David F
Neuroradiology Research Laboratory, Department of Radiology, Mayo Clinic, USA
Neuroradiology Research Laboratory, Department of Radiology, Mayo Clinic, USA.
Interv Neuroradiol. 2016 Jun;22(3):299-303. doi: 10.1177/1591019916628202. Epub 2016 Feb 3.
The dual-layer Woven EndoBridge (WEB) device (WEB II) is designed to improve the performance of the first-generation WEB device. This study was performed to evaluate the acute and chronic performance of WEB II for aneurysm occlusion in an elastase-induced aneurysm model in rabbits. We implanted WEB II devices in 36 elastase-induced aneurysms and followed up for one, three, six, and 12 months. Degree of aneurysm occlusion at follow-up was graded on the Web Occlusion Scale (WOS): Grade A, complete aneurysm occlusion; Grade B, complete occlusion with recess filling; Grade C, residual neck filling; and Grade D, residual aneurysm filling. Hematoxylin and eosin staining was performed for histological assessment of aneurysm healing. Grades A, B, C, and D aneurysm occlusion at one-month follow-up were noted in three (17%), three (17%), eight (44%), and four (22%) of 18 cases, respectively. At the three-month time point Grades A, B, C, and D were shown in two (33%), two (33%), one (17%), and one (17%) aneurysms. Six months after treatment, one (17%), two (33%), two (33%), and one (17%) cases demonstrated Grades A, B, C, and D occlusion. At the 12-month time point, Grades B, C, and D were shown in three (50%), two (33%), and one (17%) aneurysms. Histologic evaluation showed progressive thrombus organization within aneurysm lumen from one to 12 months. These results indicated that the WEB II device can achieve high rates of aneurysm occlusion over time in experimental aneurysms.
双层编织式血管内桥接(WEB)装置(WEB II)旨在提高第一代WEB装置的性能。本研究旨在评估WEB II在兔弹性蛋白酶诱导的动脉瘤模型中用于动脉瘤闭塞的急性和慢性性能。我们将WEB II装置植入36个弹性蛋白酶诱导的动脉瘤中,并随访1、3、6和12个月。随访时动脉瘤闭塞程度根据血管内桥接闭塞量表(WOS)分级:A级,动脉瘤完全闭塞;B级,完全闭塞伴隐窝填充;C级,残留颈部填充;D级,残留动脉瘤填充。进行苏木精和伊红染色以对动脉瘤愈合进行组织学评估。在18例病例中,1个月随访时A级、B级、C级和D级动脉瘤闭塞分别见于3例(17%)、3例(17%)、8例(44%)和4例(22%)。在3个月时间点,2例(33%)、2例(33%)、1例(17%)和1例(17%)动脉瘤表现为A级、B级、C级和D级。治疗6个月后,1例(17%)、2例(33%)、2例(33%)和1例(17%)病例表现为A级、B级、C级和D级闭塞。在12个月时间点,3例(50%)、2例(33%)和1例(17%)动脉瘤表现为B级、C级和D级。组织学评估显示,动脉瘤腔内血栓组织在1至12个月内逐渐形成。这些结果表明,随着时间的推移,WEB II装置在实验性动脉瘤中可实现较高的动脉瘤闭塞率。