Department of Neuroradiology, Saarland University Hospital and Saarland University Faculty of Medicine, Homburg, Saarland, Germany.
Department of Neuropathology, Saarland University Hospital and Saarland University Faculty of Medicine, Homburg, Saarland, Germany.
J Neurointerv Surg. 2022 Mar;14(3):286-290. doi: 10.1136/neurintsurg-2021-017308. Epub 2021 May 4.
Recently, liquid embolic agents have emerged for the endovascular treatment of cerebral aneurysms. Here we describe the in vivo performance of a novel liquid embolization agent (GPX Embolic Device).
Elastase-induced aneurysms were embolized with a GPX prototype under balloon assistance. Digital subtraction angiography was performed pre-deployment and immediately after, and at 5, 10, and 30 min post-deployment in 10 rabbits and at 1 month in 8 rabbits. The early post-deployment intra-aneurysmal flow was graded as unchanged, moderately diminished, or completely absent. At 1 month the status of aneurysm occlusion was evaluated. Adhesion to catheter material and migration of GPX was assessed.
The mean aneurysm neck diameter, width, and height were 3.6±1.0 mm, 3.0±0.8 mm, and 7.4±1.4 mm, respectively. The mean dome-to-neck ratio was 0.9±0.2. Complete stagnation of intra-aneurysmal flow was observed in 9 of 10 aneurysms (90%) within 30 min of device deployment. One aneurysm showed moderately diminished intra-aneurysmal flow at 30 min. At 1 month, 8 aneurysms were completely occluded. There was no evidence of GPX adhesion to the catheter material. Histologically, a leukocyte and foreign body reaction to GPX was detectable 28 days after embolization.
This is the first preclinical study reporting the performance of a protype version of the GPX Embolic Device in a wide-neck aneurysm model. GPX showed promising results by achieving and maintaining high rates of complete angiographic occlusion, but may induce an inflammatory reaction.
最近,液体栓塞剂已应用于脑动脉瘤的血管内治疗。本研究描述了一种新型液体栓塞剂(GPX 栓塞装置)的体内性能。
弹性蛋白酶诱导的动脉瘤在球囊辅助下用 GPX 原型进行栓塞。在 10 只兔子中,在部署前、部署后立即、部署后 5、10 和 30 分钟以及 8 只兔子中 1 个月时进行数字减影血管造影。早期栓塞后动脉瘤内血流被评为不变、中度减少或完全消失。在 1 个月时评估动脉瘤闭塞的情况。评估导管材料的粘连和 GPX 的迁移。
平均动脉瘤颈直径、宽度和高度分别为 3.6±1.0mm、3.0±0.8mm 和 7.4±1.4mm。平均瘤颈比为 0.9±0.2。在装置部署后 30 分钟内,9 个动脉瘤(90%)中观察到动脉瘤内血流完全停滞。1 个动脉瘤在 30 分钟时显示中等程度的动脉瘤内血流减少。在 1 个月时,8 个动脉瘤完全闭塞。没有发现 GPX 与导管材料粘连的证据。组织学上,栓塞后 28 天可检测到 GPX 的白细胞和异物反应。
这是首例报道原型 GPX 栓塞装置在宽颈动脉瘤模型中性能的临床前研究。GPX 通过实现和维持高比例的完全血管造影闭塞显示出良好的结果,但可能会引起炎症反应。