title: Physiological remodeling of bifurcation aneurysms: preclinical results of the eCLIPs device.
abstract: OBJECTIVE Intracranial bifurcation aneurysms are complex lesions for which current therapy, including simple coiling, balloon- or stent-assisted coiling, coil retention, or intrasaccular devices, is inadequate. Thromboembolic complications due to a large burden of intraluminal metal, impedance of access to side branches, and a high recurrence rate, due largely to the unmitigated high-pressure flow into the aneurysm (water hammer effect), are among the limitations imposed by current therapy. The authors describe herein a novel device, eCLIPs, and its use in a preclinical laboratory study that suggests the device's design and functional features may overcome many of these limitations. METHODS A preclinical model of wide-necked bifurcation aneurysms in rabbits was used to assess functional features and efficacy of aneurysm occlusion by the eCLIPs device. RESULTS The eCLIPs device, in bridging the aneurysm neck, allows coil retention, disrupts flow away from the aneurysm, leaves the main vessel and side branches unencumbered by intraluminal metal, and serves as a platform for endothelial growth across the neck, excluding the aneurysm from the circulation. CONCLUSIONS The eCLIPs device permits physiological remodeling of the bifurcation.
authors.affiliation: 1Department of Medical Imaging, University of Toronto.|2Diagnostic and Therapeutic Neuroradiology, St. Michael's Hospital, University of Toronto, Ontario.
authors.forename: Thomas R
authors.initials: TR
authors.lastname: Marotta
authors.affiliation: 3Department of Neurosurgery, NYU School of Medicine, NYU Langone Medical Center, New York, New York; and.
authors.forename: Howard A
authors.initials: HA
authors.lastname: Riina
authors.affiliation: 4Evasc Medical Systems Corp., Vancouver.
authors.forename: Ian
authors.initials: I
authors.lastname: McDougall
authors.affiliation: 4Evasc Medical Systems Corp., Vancouver.|5Division of Cardiology, University of British Columbia, Vancouver, British Columbia,Canada.
authors.forename: Donald R
authors.initials: DR
authors.lastname: Ricci
authors.affiliation: 6Department of Neurology/Neuroscience Institute, Christian Doppler Clinic, Paracelsus Medical University, Salzburg,Austria.
authors.forename: Monika
authors.initials: M
authors.lastname: Killer-Oberpfalzer
mesh_terms: D000818:Animals; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000379:methods*; D002533:Cerebral Angiography; D004195:Disease Models, Animal; D004621:Embolization, Therapeutic / Q000295:instrumentation* / Q000379:methods; D004867:Equipment Design; D002532:Intracranial Aneurysm / Q000601:surgery*; D002538:Intracranial Arteriovenous Malformations / Q000601:surgery*; D019635:Neurosurgical Procedures / Q000295:instrumentation*; D011183:Postoperative Complications; D011817:Rabbits; D016896:Treatment Outcome
keywords: animal experiment; bifurcation aneurysm; eBRS = eCLIPs Bifurcation Remodelling System; flow diversion; interventional neuroradiology; interventional radiology; intracranial aneurysm; neurosurgery; therapeutic embolization; vascular disorders