In vitro flow diversion effect of the ReSolv stent with the shelf technique in a bifurcation aneurysm model.

Autor:	Belanger BL; Department of Clinical Neurosciences, University of Calgary, Foothills Medical Centre, Calgary, Alberta, Canada., Morrish R; Department of Clinical Neurosciences, University of Calgary, Foothills Medical Centre, Calgary, Alberta, Canada., McClarty D; Department of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada., Barnstable C; Department of Clinical Neurosciences, University of Calgary, Foothills Medical Centre, Calgary, Alberta, Canada., Muir W; Department of Clinical Neurosciences, University of Calgary, Foothills Medical Centre, Calgary, Alberta, Canada., Ghazizadeh S; Department of Biomedical Engineering, University of Calgary, Calgary, Alberta, Canada., Eesa M; Department of Clinical Neurosciences, University of Calgary, Foothills Medical Centre, Calgary, Alberta, Canada., Fiorella D; Department of Neurosurgery, Stony Brook University, Stony Brook, New York, USA., Wong JH; Department of Clinical Neurosciences, University of Calgary, Foothills Medical Centre, Calgary, Alberta, Canada., Sadasivan C; Department of Neurosurgery, Stony Brook University, Stony Brook, New York, USA., Mitha AP; Department of Clinical Neurosciences, University of Calgary, Foothills Medical Centre, Calgary, Alberta, Canada amitha@ucalgary.ca.; Department of Biomedical Engineering, University of Calgary, Calgary, Alberta, Canada.
Jazyk:	angličtina
Zdroj:	Journal of neurointerventional surgery [J Neurointerv Surg] 2024 Feb 12; Vol. 16 (3), pp. 296-301. Date of Electronic Publication: 2024 Feb 12.
DOI:	10.1136/jnis-2022-020023
Abstrakt:	Background: Flow-diverting stents are not currently indicated for the treatment of bifurcation aneurysms, and some case series have demonstrated low occlusion rates, possibly due to a lack in neck coverage. The ReSolv stent is a unique hybrid metal/polymer stent that can be deployed with the shelf technique in order to improve neck coverage. Methods: A Pipeline, unshelfed ReSolv, and shelfed ReSolv stent were deployed in the left-sided branch of an idealized bifurcation aneurysm model. After determining stent porosity, high-speed digital subtraction angiography runs were acquired under pulsatile flow conditions. Time-density curves were created using two region of interest (ROI) paradigms (total aneurysm and left/right), and four parameters were extracted to characterize flow diversion performance. Results: The shelfed ReSolv stent demonstrated better aneurysm outflow alterations compared to the Pipeline and unshelfed ReSolv stent when using the total aneurysm as the ROI. On the left side of the aneurysm, there was no significant difference between the shelfed ReSolv stent and the Pipeline. On the right side of the aneurysm, however, the shelfed ReSolv stent had a significantly better contrast washout profile than the unshelfed ReSolv stent and the Pipeline stent. Conclusions: The ReSolv stent with the shelf technique demonstrates the potential to improve flow diversion outcomes for bifurcation aneurysms. Further in vivo testing will help to determine whether the additional neck coverage leads to better neointimal scaffolding and long-term aneurysm occlusion. Competing Interests: Competing interests: DM and SG are employed by Fluid Biomed Inc. ME is a shareholder of Fluid Biomed Inc. DF is on the editorial board of the Journal of NeuroInterventional Surgery; has received consulting, proctoring, and/or research support from Balt USA, MicroVention, Prenumbra, and Stryker; and is a shareholder of Marblehead, Mentice Inc, Neurogami Medical Inc., NV Med, and Scientia Medical. JHW is a co-founder and shareholder of Fluid Biomed Inc, and holds patents related to the technology described in this manuscript. CS has received consulting, proctoring, and/or research support from Stryker Neurovascular, Medtronic Neurovascular, Rapid Medical, Balt USA, Siemens Healthineers, and Mentice Inc. APM received research support from Evolve2Innovate, Fluid Biomedical, and Stryker Neurovascular; is a consultant for Cerus Endovascular; is a co-founder and shareholder of Fluid Biomed Inc; and holds patents related to the technology described in this manuscript. (© Author(s) (or their employer(s)) 2024. No commercial re-use. See rights and permissions. Published by BMJ.)
Databáze:	MEDLINE
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