title: Long term follow-up of the endovascular trans-vessel wall technique for parenchymal access in rabbit with full clinical integration.
abstract: OBJECTIVE
  Endovascular techniques are providing options to surgical/percutaneous cell transplantation methods. Some cells, e.g. insulin producing cells, are not suitable for intra-luminal transplantation and for such cells, other options must be found. We have constructed a "nanocatheter" with a penetrating tip for vessel perforation, thereby creating a working channel for parenchymal access by endovascular technique. To finish the procedure safely, the distal tip is detached to provide a securing plug in the vessel wall defect.
  
  
  METHODS
  We have performed interventions with full clinical integration in the superior mesenteric artery (SMA), the subclavian artery and the external carotid artery in rabbits. No hemorrhagic- or thromboembolic events occurred during the procedure. Stenosis formation and distal embolisation were analyzed by angiography and macroscopic inspection during autopsy at five, 30 and 80 days. All animals and implanted devices were also evaluated by micro-dissections and histochemical analysis.
  
  
  RESULTS
  In this study we show safety data on the trans-vessel wall technique by behavioral, angiographical and histological analysis. No stenosis formation was observed at any of the follow-up time points. No animals or organs have shown any signs of distress due to the intervention. Histological examination showed no signs of hemorrhage, excellent biocompatibility with no inflammation and a very limited fibrous capsule formation around the device, comparable to titanium implants. Further, no histological changes were detected in the endothelia of the vessels subject to intervention.
  
  
  CONCLUSIONS
  The trans-vessel wall technique can be applied for e.g. cell transplantations, local substance administration and tissue sampling with low risk for complications during the procedure and low risk for hemorrhage, stenosis development or adverse tissue reactions with an 80 days follow-up time. The benefit should be greatest in organs that are difficult or risky to reach with surgical techniques, such as the pancreas, the CNS and the heart.
authors.affiliation: Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Johan
authors.initials: J
authors.lastname: Lundberg
authors.forename: Stefan
authors.initials: S
authors.lastname: Jonsson
authors.forename: Staffan
authors.initials: S
authors.lastname: Holmin
mesh_terms: D000792:Angiography / Q000379:methods; D000818:Animals; D002342:Carotid Artery, External / Q000000981:diagnostic imaging / Q000601:surgery* / Q000648:ultrastructure; D057510:Endovascular Procedures / Q000379:methods*; D005500:Follow-Up Studies; D017538:Mesenteric Artery, Superior / Q000000981:diagnostic imaging / Q000601:surgery* / Q000648:ultrastructure; D008855:Microscopy, Electron, Scanning; D011817:Rabbits; D015203:Reproducibility of Results; D013348:Subclavian Artery / Q000000981:diagnostic imaging / Q000601:surgery* / Q000648:ultrastructure; D013997:Time Factors