Active drug-coated flow diverter in a preclinical model of intracranial stenting
Authors
King, Robert MPeker, 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
Anagnostakou, Vania
UMass Chan Affiliations
RadiologyDocument Type
Journal ArticlePublication Date
2023-06-30
Metadata
Show full item recordAbstract
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.Source
King RM, Peker A, Epshtein M, Arends JM, Brochu AB, Raskett CM, Slazas KJ, Puri AS, Arthur AS, Fiorella D, Gounis MJ, Anagnostakou V. Active drug-coated flow diverter in a preclinical model of intracranial stenting. J Neurointerv Surg. 2023 Jun 30:jnis-2023-020391. doi: 10.1136/jnis-2023-020391. Epub ahead of print. PMID: 37399337.DOI
10.1136/jnis-2023-020391Permanent Link to this Item
http://hdl.handle.net/20.500.14038/52449PubMed ID
37399337Rights
© Author(s) (or their employer(s)) 2023. No commercial re-use. See rights and permissions. Published by BMJ.ae974a485f413a2113503eed53cd6c53
10.1136/jnis-2023-020391