Endovascular treatment of experimental wide neck aneurysms: comparison of results using coils or cyanoacrylate with the assistance of an aneurysm neck bridge device.
OBJECTIVE
Endovascular treatment of wide neck aneurysms often results in incomplete occlusion or aneurysm recurrence. The two goals of the present study were to compare results of coil embolization with or without the assistance of an aneurysm neck bridge device (ANBD) and to explore the use of this instrument to control cyanoacrylate embolization.


METHODS
Wide necked bifurcation aneurysms were constructed in 28 dogs. Coil embolization of the aneurysms was performed 2 to 4 weeks later, with (n = 11) or without (n = 10) ANBD assistance. In seven other animals, embolization was performed with cyanoacrylate, injected under the protection of ANBDs. Angiographic results were compared immediately after and at 3 and 12 weeks. Neointima formation at the neck was also compared between groups at 12 weeks.


RESULTS
Initial angiographic results and recurrences at 12 weeks were not significantly different in aneurysms coiled with or without ANBDs. Neointimal scores were also similar. The use of one ANBD at the neck was not sufficient to safely deliver cyanoacrylate into aneurysms. Cyanoacrylate embolization led to improved angiographic results (P =.05) and to better neointimal sealing of the neck of the aneurysms at 12 weeks (P =.004).


CONCLUSIONS
ANBDs did not prevent recanalization and recurrences after coil embolization of wide neck aneurysms in this animal study. ANBD-assisted cyanoacrylate embolization was unsafe but could decrease recurrences at 12 weeks.
Raymond
Jean
J
Centre de Recherche, Centre Hospitalier de l'Université de Montréal, Montreal, Quebec, Canada.
Salazkin
Igor
I
Georganos
Stavros
S
Guilbert
François
F
Desfaits
Anne-Cécile
AC
Gevry
Guylaine
G
Weill
Alain
A
Roy
Daniel
D
D000818:Animals; D001807:Blood Vessel Prosthesis; D017536:Carotid Artery, Common / Q000000981:diagnostic imaging / Q000601:surgery; D016893:Carotid Stenosis / Q000150:complications / Q000628:therapy; D020099:Coated Materials, Biocompatible / Q000627:therapeutic use; D003487:Cyanoacrylates / Q000494:pharmacology; D004195:Disease Models, Animal; D004285:Dogs; D004621:Embolization, Therapeutic / Q000295:instrumentation; D004869:Equipment Safety; D005500:Follow-Up Studies; D002532:Intracranial Aneurysm / Q000150:complications / Q000628:therapy*; D009333:Neck / Q000098:blood supply* / Q000000981:diagnostic imaging / Q000473:pathology*; D010984:Platinum / Q000627:therapeutic use; D011859:Radiography; D012008:Recurrence; D012720:Severity of Illness Index; D016896:Treatment Outcome; D017539:Tunica Intima / Q000000981:diagnostic imaging / Q000601:surgery; D014656:Vascular Surgical Procedures / Q000295:instrumentation
D020099:Coated Materials, Biocompatible; D003487:Cyanoacrylates; D010984:Platinum