Title

The Importance of Wall Apposition in Flow Diverters

UMMS Affiliation

Department of Radiology, Division of Neuroimaging and Intervention; New England Center for Stroke Research

Publication Date

2018-04-04

Document Type

Article

Disciplines

Equipment and Supplies | Neurology | Radiology | Surgery

Abstract

BACKGROUND: It is assumed that high pore densities in flow diverters (FDs) are beneficial for intracranial aneurysm (IA) healing. However, various animal studies are not conclusive on the issue, suggesting that other factors are in play. One important factor might be wall apposition.

OBJECTIVE: To (1) determine the relationship between FD pore density and aneurysm occlusion, and (2) determine the relationship between FD wall apposition and aneurysm occlusion.

METHODS: Saccular aneurysms were microsurgically created in the aorta of 36 Wistar rats. Twelve rats received a low pore density FD (10 pores/mm2), 12 rats received a high pore density FD (23 pores/mm2), and the remaining 12 rats served as a control group. Six animals from each group were sacrificed 1 and 3 mo after surgery. We determined aneurysm occlusion, the number of struts not in contact with the aorta wall, and the average distance from malapposed struts to aorta wall through histology.

RESULTS: No significant differences were found in aneurysm occlusion between the low pore density and high pore density groups (P > .05) after 1 and 3 mo of follow-up. The average number of malapposed struts was lower for the occluded aneurysm group (4.4 +/- 1.9) compared to the nonoccluded aneurysm group (7.7 +/- 2.6, P < .01). The average distance between malapposed struts and parent artery wall was lower for the occluded aneurysm group (33.9 mum +/- 11.5 mum) than for the nonoccluded aneurysm group (48.7 mum +/- 18.8 mum, P < .05).

CONCLUSION: Wall apposition is more important than pore density for aneurysm occlusion.

DOI of Published Version

10.1093/neuros/nyy092

Source

Neurosurgery. 2018 Apr 4. doi: 10.1093/neuros/nyy092. Link to article on publisher's site

Journal/Book/Conference Title

Neurosurgery

Related Resources

Link to Article in PubMed

PubMed ID

29659995

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