Endovascular treatment of experimental aneurysms with use of fibroblast transfected with replication-deficient adenovirus containing bone morphogenetic protein-13 gene.
OBJECTIVE
Modified coils have failed to improve long-term recanalization of aneurysms. This study examined whether ex vivo transduction of replication-deficient adenovirus containing the bone morphogenetic protein-13 gene (Ad-BMP-13) in fibroblast allografts would improve angiographic results via increased collagen synthesis, compared with fibroblast-coated platinum coils (FBC) and bare platinum coils (PA).


METHODS
Aneurysms were embolized with Ad-BMP-13-coated coils (n = 20). Rabbits were sacrificed at 14 days and at 1, 3, and 6 months after implantation. Digital subtraction angiography (DSA) evaluated stability after embolization. Histologic specimens were examined with a qualitative grading system. Masson trichrome evaluated collagen deposition. Findings were compared with previously reported controls for PA and FBC in the same model and time points.


RESULTS
The grading system showed a greater total score (P = .0002) in Ad-BMP-13 (6.8 +/- 1.6) and FBC (6.3 +/- 2.4) compared with PA (4.7 +/- 2.4). A group main effects test showed that aneurysm neck tissue coverage in Ad-BMP-13 (2.5 +/- 1.1) was higher (P = .0007) than both FBC (1.6 +/- 1.4) and PA (0.9 +/- 1.1). Ad-BMP-13 had more (P < .0001) collagen deposition than the FBC and PA. One- and 3-month Ad-BMP-13 collagen depositions increased (P < .05) over the FBC and PA. Finally, Ad-BMP-13 showed radiographic stability in 15 (75%) cases, coil compaction in 4 (20%) cases, and progressive occlusion in 1 (5%) case. There were no differences in angiographic results (P = .6522).


CONCLUSIONS
The Ad-BMP-13-coated coils can improve neck coverage and dome fibrosis in the rabbit model, even in the absence of observed differences in angiographic outcome.
Dai
D
D
Neuroradiology Research Laboratory, Department of Radiology, Mayo Clinic, Rochester, MN 55905, USA.
Ding
Y H
YH
Danielson
M A
MA
Kadirvel
R
R
Helm
G A
GA
Lewis
D A
DA
Cloft
H J
HJ
Kallmes
D F
DF
D000256:Adenoviridae / Q000235:genetics* / Q000378:metabolism; D015901:Angiography, Digital Subtraction; D000818:Animals; D019485:Bone Morphogenetic Proteins / Q000378:metabolism; D002533:Cerebral Angiography; D020099:Coated Materials, Biocompatible; D003094:Collagen / Q000096:biosynthesis; D004621:Embolization, Therapeutic / Q000295:instrumentation*; D005347:Fibroblasts / Q000637:transplantation*; D002532:Intracranial Aneurysm / Q000000981:diagnostic imaging / Q000378:metabolism / Q000628:therapy*; D010984:Platinum; D011817:Rabbits; D014162:Transfection
D019485:Bone Morphogenetic Proteins; D020099:Coated Materials, Biocompatible; D010984:Platinum; D003094:Collagen