Longitudinal Monitoring of Flow-Diverting Stent Tissue Coverage After Implant in a Bifurcation Model Using Neurovascular High-Frequency Optical Coherence Tomography
Authors
Caroff, JildazKing, Robert M.
Ughi, Giovanni J.
Marosfoi, Miklos G.
Langan, Erin T.
Raskett, Christopher M.
Puri, Ajit S.
Gounis, Matthew J.
Document Type
Journal ArticlePublication Date
2020-05-28Keywords
EndothelializationFlow 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
Analytical, Diagnostic and Therapeutic Techniques and Equipment
Cardiovascular Diseases
Nervous System Diseases
Neurosurgery
Radiology
Metadata
Show full item recordAbstract
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.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
DOI
10.1093/neuros/nyaa208Permanent Link to this Item
http://hdl.handle.net/20.500.14038/48440PubMed ID
32463884Related Resources
ae974a485f413a2113503eed53cd6c53
10.1093/neuros/nyaa208