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    High-resolution image-guided WEB aneurysm embolization by high-frequency optical coherence tomography

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    Authors
    Vardar, Zeynep
    King, Robert M.
    Kraitem, Afif
    Langan, Erin T.
    Peterson, Lindsy M.
    Duncan, Benjamin H.
    Raskett, Christopher M.
    Anagnostakou, Vania
    Gounis, Matthew J.
    Puri, Ajit S.
    Ughi, Giovanni J.
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    UMass Chan Affiliations
    New England Center for Stroke Research
    Department of Radiology
    Document Type
    Journal Article
    Publication Date
    2020-09-28
    Keywords
    aneurysm
    device
    intervention
    laser
    Bioimaging and Biomedical Optics
    Biomedical Devices and Instrumentation
    Cardiovascular Diseases
    Radiology
    
    Metadata
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    Link to Full Text
    https://doi.org/10.1136/neurintsurg-2020-016447
    Abstract
    BACKGROUND: High-frequency optical coherence tomography (HF-OCT) is an intra-vascular imaging technique capable of assessing device-vessel interactions at spatial resolution approaching 10 microm. We tested the hypothesis that adequately deployed Woven EndoBridge (WEB) devices as visualized by HF-OCT lead to higher aneurysm occlusion rates. METHODS: In a leporine model, elastase-induced aneurysms (n=24) were treated with the WEB device. HF-OCT and digital subtraction angiography (DSA) were performed following WEB deployment and repeated at 4, 8, and 12 weeks. Protrusion (0-present, 1-absent) and malapposition (0-malapposed, 1-neck apposition > 50%) were binary coded. A device was considered 'adequately deployed' by HF-OCT and DSA if apposed and non-protruding. Aneurysm healing on DSA was reported using the 4-point WEB occlusion score: A or B grades were considered positive outcome. Neointimal coverage was quantified on HF-OCT images at 12 weeks and compared with scanning electron microscopy (SEM). RESULTS: Adequate deployment on HF-OCT correlated with positive outcome (P=0.007), but no statistically significant relationship was found between good outcome and adequate deployment on DSA (P=0.289). Absence of protrusion on HF-OCT correlated with a positive outcome (P=0.006); however, malapposition alone had no significant relationship (P=0.19). HF-OCT showed a strong correlation with SEM for the assessment of areas of neointimal tissue (R(2)=0.96; P < 0.001). More neointimal coverage of 78%+/-32% was found on 'adequate deployment' cases versus 31%+/-24% for the 'inadequate deployment' cases (P=0.001). CONCLUSION: HF-OCT visualizes features that can determine adequate device deployment to prognosticate early aneurysm occlusion following WEB implantation and can be used to longitudinally monitor aneurysm healing progression.
    Source

    Vardar Z, King RM, Kraitem A, Langan ET, Peterson LM, Duncan BH, Raskett CM, Anagnostakou V, Gounis MJ, Puri AS, Ughi GJ. High-resolution image-guided WEB aneurysm embolization by high-frequency optical coherence tomography. J Neurointerv Surg. 2020 Sep 28:neurintsurg-2020-016447. doi: 10.1136/neurintsurg-2020-016447. Epub ahead of print. PMID: 32989033. Link to article on publisher's site

    DOI
    10.1136/neurintsurg-2020-016447
    Permanent Link to this Item
    http://hdl.handle.net/20.500.14038/48459
    PubMed ID
    32989033
    Related Resources

    Link to Article in PubMed

    ae974a485f413a2113503eed53cd6c53
    10.1136/neurintsurg-2020-016447
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