Long-term histopathologic changes in canine aneurysms embolized with Guglielmi detachable coils.
OBJECTIVE
To evaluate the long-term histologic changes, including those in the ultrastructure of the neoendothelium, occurring in experimental canine aneurysms obliterated with Guglielmi detachable coils.


METHODS
Ten experimental aneurysms were surgically created in mongrel dogs using side-to-side jugular carotid fistulas that were subsequently ligated to form blind pouch venous aneurysms dependent on the carotid circulation. The aneurysms were obliterated with Guglielmi detachable coils, and the animals were kept in observation. Six months after the endovascular obliteration of the aneurysms, repeat carotid arteriography was performed to assess for potential recanalization of the aneurysms. The animals were then killed and submitted for autopsy. The carotid artery and the embolized aneurysm were resected and studied with light and electron microscopy.


RESULTS
Both completely obliterated and recanalized aneurysms were excluded from the parent circulation by an endothelialized layer of connective tissue. The fundus of the aneurysm was completely obliterated by heavy reactive fibrous tissue surrounding the coils with very minimal, if any, inflammatory reaction. The neointima is composed of three well-identifiable layers, the most superficial of which is formed of new endothelial cells positioned next to each other in a cobblestone fashion over a basal membrane.


CONCLUSIONS
In the absence of histologic data in human aneurysms obliterated with Guglielmi detachable coils, several observations made in our experimental study help in the understanding of the long-term results expected from this endovascular technique.
Mawad
M E
ME
Department of Radiology, Baylor College of Medicine, Houston, Tex.
Mawad
J K
JK
Cartwright
J
J
Gokaslan
Z
Z
D000783:Aneurysm / Q000000981:diagnostic imaging / Q000473:pathology* / Q000628:therapy*; D000818:Animals; D001166:Arteriovenous Shunt, Surgical; D001485:Basement Membrane / Q000648:ultrastructure; D017536:Carotid Artery, Common / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D002462:Cell Membrane / Q000648:ultrastructure; D003094:Collagen; D003238:Connective Tissue / Q000473:pathology; D004195:Disease Models, Animal; D004285:Dogs; D004621:Embolization, Therapeutic / Q000295:instrumentation*; D004730:Endothelium, Vascular / Q000473:pathology; D004867:Equipment Design; D005355:Fibrosis; D005549:Foreign-Body Reaction / Q000473:pathology; D007601:Jugular Veins / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D008855:Microscopy, Electron, Scanning; D009131:Muscle, Smooth, Vascular / Q000473:pathology; D011859:Radiography; D012008:Recurrence; D017539:Tunica Intima / Q000473:pathology
D003094:Collagen