Title
Longitudinal Monitoring of Flow-Diverting Stent Tissue Coverage After Implant in a Bifurcation Model Using Neurovascular High-Frequency Optical Coherence Tomography
UMMS Affiliation
Department of Radiology; New England Center for Stroke Research
Publication Date
2020-05-28
Document Type
Article
Disciplines
Analytical, Diagnostic and Therapeutic Techniques and Equipment | Cardiovascular Diseases | Nervous System Diseases | Neurosurgery | Radiology
Abstract
BACKGROUND: Tissue growth over covered branches is a leading cause of delayed thrombotic complications after flow-diverter stenting (FDS). Due to insufficient resolution, no imaging modality is clinically available to monitor this phenomenon.
OBJECTIVE: To evaluate high-frequency optical coherence tomography (HF-OCT), a novel intravascular imaging modality designed for the cerebrovascular anatomy with a resolution approaching 10 microns, to monitor tissue growth over FDS in an arterial bifurcation model.
METHODS: FDS were deployed in a rabbit model (n = 6), covering the aortic bifurcation. The animals were divided in different groups, receiving dual antiplatelet therapy (DAPT) (n = 4), aspirin only (n = 1), and no treatment (n = 1). HF-OCT data were obtained in vivo at 3 different time points in each animal. For each cross-sectional image, metal and tissue coverage of the jailed ostium was quantified. Scanning electron microscopy images of harvested arteries were subsequently obtained.
RESULTS: Good quality HF-OCT data sets were successfully acquired at implant and follow-up. A median value of 41 (range 21-55) cross-sectional images were analyzed per ostium for each time point. Between 0 and 30 d after implant, HF-OCT analysis showed a significantly higher ostium coverage when DAPT was not given. After 30 d, similar growth rates were found in the DAPT and in the aspirin group. At 60 d, a coverage of 90% was reached in all groups.
CONCLUSION: HF-OCT enables an accurate visualization of tissue growth over time on FDS struts. The use of FDS in bifurcation locations may induce a drastic reduction of the jailed-branch ostium area.
Keywords
Endothelialization, Flow diverter, Intracranial aneurysm, Optical coherence tomography, aspirin, stents, heart failure, follow-up, oryctolagus cuniculus, diagnostic imaging, optical coherence tomography, implants, aortic bifurcation, fluid flow, dual anti-platelet therapy, datasets
DOI of Published Version
10.1093/neuros/nyaa208
Source
Caroff J, King RM, Ughi GJ, Marosfoi M, Langan ET, Raskett C, Puri AS, Gounis MJ. Longitudinal Monitoring of Flow-Diverting Stent Tissue Coverage After Implant in a Bifurcation Model Using Neurovascular High-Frequency Optical Coherence Tomography. Neurosurgery. 2020 May 28:nyaa208. doi: 10.1093/neuros/nyaa208. Epub ahead of print. PMID: 32463884. Link to article on publisher's site
Journal/Book/Conference Title
Neurosurgery
Related Resources
PubMed ID
32463884
Repository Citation
Caroff J, King RM, Ughi GJ, Marosfoi MG, Langan ET, Raskett CM, Puri AS, Gounis MJ. (2020). Longitudinal Monitoring of Flow-Diverting Stent Tissue Coverage After Implant in a Bifurcation Model Using Neurovascular High-Frequency Optical Coherence Tomography. Radiology Publications. https://doi.org/10.1093/neuros/nyaa208. Retrieved from https://escholarship.umassmed.edu/radiology_pubs/547