Lenz-Habijan Tim, Bhogal Pervinder, Bannewitz Catrin, Hannes Ralf, Monstadt Hermann, Simgen Andreas, Mühl-Benninghaus Ruben, Reith Wolfgang, Henkes Hans
phenox GmbH, Bochum, Germany.
Department of Interventional Neuroradiology, The Royal London Hospital, Whitechapel Road, London, E1 1BB, UK.
Eur Radiol Exp. 2019 Dec 5;3(1):47. doi: 10.1186/s41747-019-0128-z.
Flow diverters (FDs) are widely used in the treatment of intracranial aneurysms, but the required medication increases the risk of haemorrhagic complications and limits their use in the acute setting. Surface modified FDs may limit the need for dual antiplatelet therapy (DAPT). Hydrophilic polymer coating (HPC) may reduce the need of medication.
This explorative study, approved by the local authorities and the local welfare committee, compared stent behaviour and overall tissue response between HPC-coated FDs and uncoated FDs, both implanted into the common carotid arteries of eight New Zealand white rabbits. Endothelialisation, inflammatory response, and performance during implantation were assessed. Angiographic follow-up was performed to observe the patency of the devices after implantation and after 30 days. Histological examinations were performed at 30 days to assess foreign body reaction and endothelialisation. Kruskal-Wallis and Wilcoxon tests were used to compare non-parametric variables.
Angiography showed that both coated and uncoated FDs performed well during implantation. All devices remained patent during immediate follow-up and after 30 days. Histopathology showed no significant difference in inflammation within the vessel wall between the two cohorts (2.12 ± 0.75 vs. 1.96 ± 0.79, p = 0.7072). Complete endothelialisation of the stent struts was seen with very similar (0.04 ± 0.02 mm vs. 0.04 ± 0.03 mm, p = 0.892) neoendothelial thickness between the two cohorts after 30 days.
Taking into account the limitation in sample size, non-significant differences between the HPC-coated and uncoated FDs regarding implantation, foreign body response, and endothelialisation were found.
血流导向装置（FDs）广泛应用于颅内动脉瘤的治疗，但所需药物会增加出血并发症的风险，并限制其在急性情况下的使用。表面改性的FDs可能会减少双联抗血小板治疗（DAPT）的需求。亲水性聚合物涂层（HPC）可能会减少药物需求。
本探索性研究经当地政府和当地福利委员会批准，比较了植入8只新西兰白兔颈总动脉的HPC涂层FDs与未涂层FDs之间的支架行为和整体组织反应。评估了内皮化、炎症反应和植入过程中的性能。进行血管造影随访以观察植入后及30天后装置的通畅情况。在30天时进行组织学检查以评估异物反应和内皮化。使用Kruskal-Wallis和Wilcoxon检验比较非参数变量。
血管造影显示，涂层和未涂层的FDs在植入过程中表现良好。所有装置在即刻随访和30天后均保持通畅。组织病理学显示，两组血管壁内的炎症无显著差异（2.12±0.75 vs. 1.96±0.79，p = 0.7072）。30天后，两组支架支柱完全内皮化，新生内膜厚度非常相似（0.04±0.02 mm vs. 0.04±0.03 mm，p = 0.892）。
考虑到样本量的限制，发现HPC涂层FDs与未涂层FDs在植入、异物反应和内皮化方面无显著差异。
