Title

High frequency optical coherence tomography assessment of homogenous neck coverage by intrasaccular devices predicts successful aneurysm occlusion

UMMS Affiliation

New England Center for Stroke Research, Department of Radiology

Publication Date

2019-04-29

Document Type

Article

Disciplines

Animal Experimentation and Research | Cardiovascular Diseases | Cardiovascular System | Diagnosis | Equipment and Supplies | Radiology | Surgery | Surgical Procedures, Operative | Therapeutics

Abstract

BACKGROUND: High frequency optical coherence tomography (HF-OCT) is a novel intravascular imaging technology developed for use in the cerebral vasculature. We hypothesize that HF-OCT characterization of intrasaccular device neck coverage can prognosticate exclusion of the aneurysm from the circulation.

METHODS: Bifurcation and sidewall aneurysms were made in six dogs. Seven aneurysms were treated with next generation intrasaccular devices (NGID) and four with traditional platinum coils. HF-OCT was performed to interrogate gaps in the neck coverage, coil herniation, or acute thrombus formation. Animals were re-imaged at 7, 30, 90, and 180 days following aneurysm embolization. An automated image processing method segmented the devices at the neck of the aneurysm and quantified neck coverage. The largest coverage gap was used to predict aneurysm occlusion at 180 days.

RESULTS: No difference was found in occlusion rates between the coil and NGID groups (P=0.45). Successful segmentation of the NGID construct was achieved in all cases. A coverage gap > 1 mm(2) was found to predict failed aneurysm occlusion (P=0.047). This threshold was able to predict all cases of failed occlusion. The average number of devices needed to treat the aneurysm was lower in the NGID group (1.9 vs 6.75, P=0.009). HF-OCT showed strong agreement with scanning electron microscopy (bias 0.0024 mm(2) (95% CI -0.0279, 0.0327)).

CONCLUSIONS: HF-OCT enables precise and accurate measurement of coverage gaps at the neck of aneurysms treated with intrasaccular devices in vivo. We provide in vivo evidence that uniform aneurysm neck coverage by intrasaccular devices is critical for aneurysm occlusion. permissions.

Keywords

aneurysm, angiography, coil, device, technology

DOI of Published Version

10.1136/neurintsurg-2019-014843

Source

J Neurointerv Surg. 2019 Apr 29. pii: neurintsurg-2019-014843. doi: 10.1136/neurintsurg-2019-014843. [Epub ahead of print] Link to article on publisher's site

Journal/Book/Conference Title

Journal of neurointerventional surgery

Related Resources

Link to Article in PubMed

PubMed ID

31036558

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