title: The Derivo Embolization Device, a Second-Generation Flow Diverter for the Treatment of Intracranial Aneurysms, Evaluated in an Elastase-Induced Aneurysm Model.
abstract: OBJECTIVE
  In recent years, flow diverters have provided a promising alternative to treat complex intracranial aneurysms. In this study, we compare a second-generation flow-diverting device (Derivo Embolization Device) with its prototype flow diverter, in the treatment of elastase-induced aneurysms in New Zealand white rabbits.
  
  
  METHODS
  The Derivo Embolization Device is a self-expanding stent consisting of 48 nitinol wires. The device was implanted across the necks of 17 elastase-induced aneurysms in New Zealand white rabbits. One additional device was implanted in the abdominal aorta of each animal covering the origin of lumbar arteries. Follow-up was performed after 3 months (n = 8) and 6 months (n = 9) under continuous double antiplatelet therapy. Statuses of angiographic and histological aneurysm occlusion as well as patency of branch arteries and neointimal growth were evaluated and compared with its prototype flow diverter.
  
  
  RESULTS
  The Derivo Embolization Device provided advanced visibility and flexibility, which led to more accurate navigation and placement. Complete aneurysm occlusion rates were noted in 15 cases (88 %), respectively, compared with 5 cases (28 %) with the first-generation device (p = 0.001). Neointimal growth and diameter stenosis were significantly less with the Derivo Embolization Device and declining after 6 months follow-up in the abdominal aorta. Extreme device oversizing led to distal occlusion of the parent vessel in three cases. Covered branch arteries remained patent throughout the entire period of observation.
  
  
  CONCLUSIONS
  The Derivo Embolization Device provides excellent occlusion of elastase-induced aneurysms while preserving branch arteries.
authors.affiliation: Departments of Neuroradiology, Saarland University Hospital, Kirrbergerstraße1, 66424, Homburg/Saar, Germany.
authors.forename: D
authors.initials: D
authors.lastname: Ley
authors.affiliation: Departments of Neuroradiology, Saarland University Hospital, Kirrbergerstraße1, 66424, Homburg/Saar, Germany.
authors.forename: R
authors.initials: R
authors.lastname: Mühl-Benninghaus
authors.affiliation: Departments of Neuroradiology, Saarland University Hospital, Kirrbergerstraße1, 66424, Homburg/Saar, Germany.
authors.forename: U
authors.initials: U
authors.lastname: Yilmaz
authors.affiliation: Departments of Neuroradiology, Saarland University Hospital, Kirrbergerstraße1, 66424, Homburg/Saar, Germany.
authors.forename: H
authors.initials: H
authors.lastname: Körner
authors.affiliation: Acandis GmbH, Pforzheim, Germany.
authors.forename: G F M
authors.initials: GFM
authors.lastname: Cattaneo
authors.affiliation: Acandis GmbH, Pforzheim, Germany.
authors.forename: W
authors.initials: W
authors.lastname: Mailänder
authors.affiliation: Departments of Pathology, Saarland University Hospital, Homburg/Saar, Germany.
authors.forename: Y-J
authors.initials: YJ
authors.lastname: Kim
authors.affiliation: Departments of Cardiology, Saarland University Hospital, Homburg/Saar, Germany.
authors.forename: B
authors.initials: B
authors.lastname: Scheller
authors.affiliation: Departments of Neuroradiology, Saarland University Hospital, Kirrbergerstraße1, 66424, Homburg/Saar, Germany.
authors.forename: W
authors.initials: W
authors.lastname: Reith
authors.affiliation: Departments of Neuroradiology, Saarland University Hospital, Kirrbergerstraße1, 66424, Homburg/Saar, Germany. andreassimgen@googlemail.com.
authors.forename: A
authors.initials: A
authors.lastname: Simgen
mesh_terms: D000818:Animals; D002533:Cerebral Angiography; D004621:Embolization, Therapeutic / Q000295:instrumentation / Q000379:methods; D005260:Female; D005858:Germany; D002532:Intracranial Aneurysm / Q000628:therapy*; D010196:Pancreatic Elastase; D011817:Rabbits; D015607:Stents; D016896:Treatment Outcome
chemical_list: D010196:Pancreatic Elastase
keywords: Abdominal Aorta; Diameter Stenosis; Digital Subtraction Angiography; Intracranial Aneurysm; Subclavian Artery