title: In-vitro thrombogenicity assessment of flow diversion and aneurysm bridging devices.
abstract: Endoluminal devices such as metallic flow diversion (FD) and aneurysm bridging (AB) stents are used for treatment of intracranial aneurysms. Treatments are associated with thrombogenic events mandating the use of dual antiplatelet therapy in all cases. In the current in vitro study, we utilize a slow binding fluorogenic thrombin specific substrate to measure the thrombin generation potential of six devices: four FD devices (Pipeline™ Flex embolization device, Pipeline™ Flex embolization device with Shield Technology™, SILK+, FRED™) and two AB devices (Solitaire™ AB, LEO+). We show that the Pipeline™ Flex embolization device with Shield Technology™ has significantly lower peak thrombin and takes significantly longer time to achieve peak thrombin (time to peak) compared to the other three FD devices (p < 0.05), with statistically similar results to the less thrombogenic AB devices. We conclude that surface modification of endoluminal stents could be an effective method to mitigate thrombogenic complications.
authors.affiliation: Venous Vascular R&D, Medtronic, 15 Hampshire St., Mansfield, MA, 02048, USA.
authors.forename: Gaurav
authors.initials: G
authors.lastname: Girdhar
authors.affiliation: Neurovascular R&D, Medtronic, 9775 Toledo Way, Irvine, CA, 92618, USA.
authors.forename: Junwei
authors.initials: J
authors.lastname: Li
authors.affiliation: Houston Methodist Hospital, 6565 Fannin Street, B490, Houston, TX, 77030, USA.
authors.forename: Larisa
authors.initials: L
authors.lastname: Kostousov
authors.affiliation: Neurovascular R&D, Medtronic, 9775 Toledo Way, Irvine, CA, 92618, USA.
authors.forename: John
authors.initials: J
authors.lastname: Wainwright
authors.affiliation: Department of Laboratories, Seattle Children's Hospital, OC.8.720, 4800 Sandpoint Way NE, Seattle, WA, 98105, USA. wayne.chandler@seattlechildrens.org.
authors.forename: Wayne L
authors.initials: WL
authors.lastname: Chandler
mesh_terms: D000783:Aneurysm / Q000628:therapy*; D004621:Embolization, Therapeutic / Q000379:methods*; D006801:Humans; D015607:Stents / Q000009:adverse effects*; D013927:Thrombosis / Q000209:etiology / Q000378:metabolism*
keywords: Aneurysm bridging devices; Flow diversion devices; Thrombin generation