Endovascular Treatment Of Wide-necked Aneurysms With Stents And Coils In A Canine Model

Patients who present with an acutely ruptured intracranial aneurysm have 25%~60% associated rate of mortality. Clipping is an effective method, but the surgical treatment of aneurysms is a complex, difficult and risky procedure. Since the development of the Guglielmi detechable coil (GDC), the endovascular treatment of saccular aneurysms has become more reliable and reasonably safe. In the treatment of wide-necked aneurysms, coil herniation into the parent artery and its subsequent occlusion makes this also a risky technique. Although 3D coil, Trispan coil and Remodeling technique may prevent coil herniation into the parent artery in the treatment of partial wide-necked aneurysms, but they are still impossible to treat some of the extremely wide-necked and fusiform aneurysm. Whereas, treatment with covered stent and liquid polymer can cause servere complications, such as thrombolic events and occlusion of vital side branches. Porous stent placement combined with coils seems an attractive solution for the treatment of wide-necked aneurysms. The change of blood flow in the aneurysms after stent implantation or with coil placement is not very clear until now. Histopathological study after treatment of the wide-necked aneurysms with combination stent and coils has not been reported. Whether neointima can cover the orifice of the wide-necked aneurysms is a hallmark of anatomic healing of the aneurysms, off course, is one of the major aspect of this study.Partâ… . Establishment of wide-necked aneurysm in canine modelOBJECTIVE: To observe hemodynamics and histopathology of the wide-necked aneurysms in canine model. METHODS: Bilateral side-wall wide-necked aneurysms were surgically constructed on the carotid arteries of 17 dogs. After the creation of aneurysm model, ultrasonography and angiography were used to evaluate the morphology and hemodynamics of the aneurysms. Histopatholgical study were performed in two aneurysms. RESULTS: Twenty- four of 34 experimental aneurysms created were confirmed saccular and wide-necked by ultrasonography. Angiograms showed whirl-like, vortex flow of blood within the lumens of the aneurysms. CONCLUSIONS: A canine side-wall wide-necked aneurysm model can be created on carotid artery by surgery.