1Department of Clinical Neurosciences, University of Calgary.
2Fluid Biotech Inc., Calgary.
J Neurosurg. 2022 Apr 1;137(6):1794-1800. doi: 10.3171/2022.1.JNS212975. Print 2022 Dec 1.
Flow-diverting stents with a resorbable component have significant theoretical benefits over full metal stents, although currently there are none in clinical use. In this study, the authors sought to determine the immediate flow-diversion characteristics of a novel primarily bioresorbable flow-diverting stent.
Bioresorbable stents were deployed into glass tube models to determine porosity and pore density. In vitro flow diversion behavior was evaluated using high frame rate angiography under pulsatile flow conditions in a patient-specific silicone aneurysm model treated with the resorbable stent as well as the Surpass Evolve stent. In vivo flow diversion was characterized by deployment into 20 rabbit saccular aneurysm models, and grading was based on the O'Kelly-Marotta scale and the 4F-flow diversion predictive score.
Porosities and pore densities of the bioresorbable stent were in the flow-diverting range for all target vessel diameters. Quantified results of immediate angiography after placement of the bioresorbable stent into a silicone aneurysm model demonstrated greater flow diversion compared to the Evolve stent. Bioresorbable stent placement in saccular aneurysm models resulted in an immediate O'Kelly-Marotta grade of A3 or better and a 4F-flow diversion predictive score of 4 or better in all cases.
The bioresorbable stent has immediate flow-diversion characteristics that are comparable to commercially available metal stents. Longer-term studies are underway to determine the ability of the resorbable fibers to act as a neointimal scaffold and result in long-term aneurysm occlusion.
与全金属支架相比,具有可吸收成分的血流导向支架具有显著的理论优势,尽管目前尚未在临床中使用。在本研究中,作者旨在确定新型主要可吸收血流导向支架的即刻血流分流特性。
将可吸收支架部署到玻璃管模型中,以确定其孔隙率和孔径密度。在脉动流条件下,使用高帧率血管造影术在患者特定的硅酮动脉瘤模型中评估体外血流分流行为,该模型用可吸收支架和 Surpass Evolve 支架进行治疗。在 20 个兔囊状动脉瘤模型中进行体内血流分流,根据 O'Kelly-Marotta 分级和 4F 血流分流预测评分进行分级。
所有目标血管直径的可吸收支架的孔隙率和孔径密度均处于血流分流范围内。将可吸收支架放置在硅酮动脉瘤模型中后的即刻血管造影定量结果表明,与 Evolve 支架相比,血流分流更多。在所有情况下,可吸收支架放置在囊状动脉瘤模型中均立即达到 O'Kelly-Marotta 分级 A3 或更高,4F 血流分流预测评分达到 4 或更高。
可吸收支架具有与市售金属支架相当的即刻血流分流特性。正在进行长期研究,以确定可吸收纤维作为新生内膜支架的能力,并实现长期动脉瘤闭塞。