OCT and IVUS evaluating stent apposition and endothelialization after FD implantation in aneurysm animal models
10.3760/cma.j.cn115354-20240201-00087
- VernacularTitle:OCT和IVUS在血流导向装置植入动脉瘤动物模型后贴壁及内皮化评估中的应用价值研究
- Author:
Ji MA
1
;
Shuhai LONG
;
Jie YANG
;
Zhen LI
;
Haiqiang SANG
;
Yi TANG
;
Yuncai RAN
;
Yong ZHANG
;
Baohong WEN
;
Shanshan XIE
;
Ke CHEN
;
Enjie LIU
;
Xinwei HAN
;
Tengfei LI
Author Information
1. 郑州大学第一附属医院放射介入科，郑州大学介入治疗研究所，郑州 450052
- Keywords:
Intracranial aneurysm;
Flow diverter;
Optical coherence tomography;
Intravascular ultrasound;
Incomplete stent apposition
- From:
Chinese Journal of Neuromedicine
2024;23(3):256-262
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the application value of optical coherence tomography (OCT) and intravascular ultrasound (IVUS) in evaluating flow diverter (FD) apposition and endothelialization in aneurysm animal models, and analyze the effect of incomplete stent apposition (ISA) on aneurysm lumen healing and stent endothelialization.Methods:Lateral common carotid artery aneurysm models in swines were established by surgical method and then FD was implanted. Immediately after surgery, OCT and IVUS were used to evaluate the locations and degrees of ISA, and difference between these 2 methods in evaluating FD apposition was compared. DSA was performed at 12 weeks after surgery to evaluate the aneurysm occlusion (Kamran grading) and stent patency. OCT and IVUS were used again to observe the stent endothelial situation; by comparing with histopathologic results, effect of ISA on aneurysm healing and stent endothelialization was analyzed.Results:Lateral common carotid artery aneurysm models in 6 swines were established, and 6 Tubridge FDs were successfully implanted. Compared with IVUS (3 stents, 4 locus), OCT could detect more ISA (6 stents, 14 locus); and the vascular diameter change area (7 locus), aneurysm neck area (4 locus) and the head and tail of FD (3 locus) were the main sites of FD malapposition; average distance between stent wire and vessel wall was (560.14±101.48) μm. At 12 weeks after surgery, DSA showed that 1 patient had a little residual contrast agent at the aneurysm neck (Kamran grading 3), and the remaining 5 had complete aneurysm occlusion (Kamran grading 4). One FD had moderate lumen stenosis, and the other 5 FDs had lumen patency. OCT indicated mostly disappeared acute ISA; ISA proportion decreased to 21.4 % (3/14), including 2 in the aneurysm neck and 1 in the partial stent. Histopathological results showed bare stent woven silk, without obvious endothelial coverage; in one FD with luminal stenosis, intimal hyperplasia was mainly composed of vascular smooth muscle cells.Conclusion:In carotid artery aneurysm model with FD implantation, OCT can detect more ISA than IVUS; most acute ISA have good outcome at 12 th week of follow-up, while severe ISA can cause delayed FD endothelialization and delayed aneurysm occlusion.
