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J Vasc Surg. 2007 Jun;45(6):1228-35.

The effects of stenting and endothelial denudation on aneurysm and branch occlusion in experimental aneurysm models.

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1
CHUM Notre-Dame Hospital, Montreal, Quebec, Canada.

Abstract

BACKGROUND:

Stents are increasingly used in the endovascular treatment of intracranial aneurysms. We studied the effects of stenting and endothelial denudation on aneurysm and branch vessel occlusion.

METHODS:

Bilateral lingual bifurcation venous pouch aneurysms were created in eight dogs, surgically scraping the aneurysmal endothelial lining on one side. Both arteries were immediately stented using balloon-expandable stents. In four other dogs, a wide-neck carotid bifurcation aneurysm was created, with the vein pouch denuded or not (n=2 each), followed by immediate stenting. Results were compared using angiography and pathology at 10 days (n=2), 10 (n=8), and 20 weeks (n=2). Branch occlusion between initial and final angiograms was recorded. Pathological evaluation of aneurysms was studied, with attention to neointima formation at the aneurysm ostium and around branch vessel origins.

RESULTS:

All stented and denuded lingual aneurysms were obliterated compared with two of eight lingual aneurysms that were stented alone (P=.007). None of the carotid bifurcation aneurysms became obliterated (0/4), but denuded aneurysms showed partial thrombosis (2/2). Of 68 total stent-covered branches, 5 (7%) were occluded and 17 (27%) had altered angiographic flow.

CONCLUSIONS:

Stenting led to suboptimal results in the presence of an intact endothelial layer. Endothelial denudation can promote aneurysm occlusion when combined with stenting.

PMID:
17543687
DOI:
10.1016/j.jvs.2007.02.060
[Indexed for MEDLINE]
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