1. Active drug-coated flow diverter in a preclinical model of intracranial stenting.
- Author
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King, Robert M., Peker, Ahmet, Epshtein, Mark, Arends, Jennifer M., Brochu, Alice B., Raskett, Christopher M., Slazas, Kimiko J., Puri, Ajit S., Arthur, Adam S., Fiorella, David, Gounis, Matthew J., and Anagnostakou, Vania
- Subjects
PREVENTION of surgical complications ,NEUROLOGIC examination ,STATISTICAL correlation ,BASILAR artery ,T-test (Statistics) ,STATISTICAL significance ,HEPARIN ,OPTICAL coherence tomography ,BRAIN ,DOGS ,MAGNETIC resonance imaging ,MANN Whitney U Test ,DESCRIPTIVE statistics ,THROMBOEMBOLISM ,ANIMAL experimentation ,NEURORADIOLOGY ,DATA analysis software ,DRUG-eluting stents - Abstract
Background Flow diverters carry the risk of thromboembolic complications (TEC). We tested a coating with covalently bound heparin that activates antithrombin to address TEC by locally downregulating the coagulation cascade. We hypothesized that the neuroimaging evidence of TEC would be reduced by the coating. Methods 16 dogs were implanted with overlapping flow diverters in the basilar artery, separated into two groups: heparin-coated (n=9) and uncoated (n=7). Following implantation, high-frequency optical coherence tomography (HF-OCT) was acquired to quantify acute thrombus (AT) formation on the flow diverters. MRI was performed postoperatively and repeated at 1, 2, 3, 4, and 8 weeks, consisting of T1-weighted imaging, time-0f-flight (ToF), diffusion weighted imaging (DWI), susceptibility weighted imaging (SWI), and fluid attenuated inversion recovery (FLAIR) sequences. Neurological examinations were performed throughout the 8-week duration of the study. Results The mean AT volume on coated devices was lower than uncoated (0.014 vs 0.018 mm³); however, this was not significant (P=0.3). The mean number of foci of magnetic susceptibility artifacts (MSAs) on SWI was significantly different between the uncoated and coated groups at the 1-week follow-up (P<0.02), and remained statistically different throughout the duration of the study. The AT volume showed a direct linear correlation with the MSA count and 80% of the variance in the MSA could be explained by the AT volume (P<0.001). Pathological analysis showed evidence of ischemic injury at locations of MSA. Conclusions Heparin-coated flow diverters significantly reduced the number of new MSAs after 1 week follow-up, showing the potential to reduce TEC. [ABSTRACT FROM AUTHOR]
- Published
- 2024
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