Comparison of arterial wall integration of different flow diverters in rabbits: The CICAFLOW study.

Antiplatelet therapy Endothelization Flow diverter stents Intracranial aneurysms OCT

Journal

Journal of neuroradiology = Journal de neuroradiologie
ISSN: 0150-9861
Titre abrégé: J Neuroradiol
Pays: France
ID NLM: 7705086

Informations de publication

Date de publication:
26 Aug 2023
Historique:
received: 22 06 2023
revised: 24 08 2023
accepted: 24 08 2023
pubmed: 28 8 2023
medline: 28 8 2023
entrez: 27 8 2023
Statut: aheadofprint

Résumé

New coated flow diverters (FDs) claim antithrombotic properties and increased arterial wall integration. The aim of this study is to compare in vivo endothelial coverage of coated and uncoated FD in the context of different antiplatelet regimens. Different FDs (Silk Vista - SV, Pipeline with Shield technology - PED shield and Surpass Evolve - SE) were implanted in the aorta of rabbits, all 3 in each animal with 3 different antiplatelet regimens: no antiplatelet therapy, aspirin alone, or aspirin and ticagrelor. Four weeks after FD implantation, angiography, flat-panel CT, and optical coherence tomography (OCT) were performed before harvesting the aorta. Extensive histopathology analyses were performed including environmental scanning electron microscopy (ESEM), multiphoton microscopy (MPM) and histological staining with qualitative and/or quantitative assessment of device coverage. All 23 FDs that were implanted remained patent without hyperplasia. Qualitative stent coverage assessment revealed that there were no statistically significant differences between the FD groups (p = 0.19, p = 0.45, p = 0.40, and p = 0.84 for OCT, ESEM, MPM and histology, respectively). Quantitative neointimal measurement of histological sections also showed similar results in all 3 FD groups (p = 0.70). However, there were significant differences between the 3 groups of antiplatelet regimens (p = 0.07) with a higher rate in the no antiplatelet group (p = 0.05 versus aspirin alone and p = 0.03 versus aspirin and ticagrelor). Our study provides evidence that FD integration into the arterial wall is similar with coated (PED shield) and uncoated devices (SV, SE), regardless of the antiplatelet regimen. FD integration with specific surface coverage should be promoted. APAFIS #2022011215518538.

Sections du résumé

BACKGROUND AND PURPOSE OBJECTIVE
New coated flow diverters (FDs) claim antithrombotic properties and increased arterial wall integration. The aim of this study is to compare in vivo endothelial coverage of coated and uncoated FD in the context of different antiplatelet regimens.
METHODS METHODS
Different FDs (Silk Vista - SV, Pipeline with Shield technology - PED shield and Surpass Evolve - SE) were implanted in the aorta of rabbits, all 3 in each animal with 3 different antiplatelet regimens: no antiplatelet therapy, aspirin alone, or aspirin and ticagrelor. Four weeks after FD implantation, angiography, flat-panel CT, and optical coherence tomography (OCT) were performed before harvesting the aorta. Extensive histopathology analyses were performed including environmental scanning electron microscopy (ESEM), multiphoton microscopy (MPM) and histological staining with qualitative and/or quantitative assessment of device coverage.
RESULTS RESULTS
All 23 FDs that were implanted remained patent without hyperplasia. Qualitative stent coverage assessment revealed that there were no statistically significant differences between the FD groups (p = 0.19, p = 0.45, p = 0.40, and p = 0.84 for OCT, ESEM, MPM and histology, respectively). Quantitative neointimal measurement of histological sections also showed similar results in all 3 FD groups (p = 0.70). However, there were significant differences between the 3 groups of antiplatelet regimens (p = 0.07) with a higher rate in the no antiplatelet group (p = 0.05 versus aspirin alone and p = 0.03 versus aspirin and ticagrelor).
CONCLUSION CONCLUSIONS
Our study provides evidence that FD integration into the arterial wall is similar with coated (PED shield) and uncoated devices (SV, SE), regardless of the antiplatelet regimen. FD integration with specific surface coverage should be promoted.
TRIAL REGISTRATION BACKGROUND
APAFIS #2022011215518538.

Identifiants

DOI: 10.1016/j.neurad.2023.08.005 PMID: 37634579
pubmed: 37634579
pii: S0150-9861(23)00235-3
doi: 10.1016/j.neurad.2023.08.005
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

Copyright © 2023 The Authors. Published by Elsevier Masson SAS.. All rights reserved.

Auteurs

Géraud Forestier (G)

University Hospital of Limoges, Neuroradiology Department, 2 avenue Martin Luther-King, Dupuytren, Limoges 87042, France; University of Limoges, XLIM UMR CNRS, Limoges 7252, France. Electronic address: Geraud.FORESTIER@chu-limoges.fr.

Jonathan Cortese (J)

University of Limoges, XLIM UMR CNRS, Limoges 7252, France; NEURI Brain Vascular Center, Interventional Neuroradiology, Bicêtre University-Hospital, Le Kremlin-Bicêtre, France.

Sylvia M Bardet (SM)

University of Limoges, XLIM UMR CNRS, Limoges 7252, France.

Maxime Baudouin (M)

University Hospital of Limoges, Neuroradiology Department, 2 avenue Martin Luther-King, Dupuytren, Limoges 87042, France.

Kévin Janot (K)

University of Limoges, XLIM UMR CNRS, Limoges 7252, France; Regional University Hospital Center Tours, Radiology, Diagnostic and Interventional Neuroradiology, France.

Voahirana Ratsimbazafy (V)

Service de Pharmacie, CHU de Limoges, Limoges, France; Université de Limoges, IFR 145 GEIST, Institut d'Epidémiologie Neurologique et de Neurologie Tropicale, INSERM, UMR, Limoges 1094, France.

Marie-Laure Perrin (ML)

University of Limoges, XLIM UMR CNRS, Limoges 7252, France.

Jérémy Mounier (J)

University of Limoges, XLIM UMR CNRS, Limoges 7252, France.

Claude Couquet (C)

University of Limoges, XLIM UMR CNRS, Limoges 7252, France.

Catherine Yardin (C)

University of Limoges, XLIM UMR CNRS, Limoges 7252, France; Cytology Department, Dupuytren Limoges University Hospital, France.

Yan Larragneguy (Y)

University of Limoges, XLIM UMR CNRS, Limoges 7252, France.

Flavie Souhaut (F)

University of Limoges, XLIM UMR CNRS, Limoges 7252, France.

Romain Chauvet (R)

University of Limoges, XLIM UMR CNRS, Limoges 7252, France.

Alexis Belgacem (A)

University of Limoges, XLIM UMR CNRS, Limoges 7252, France.

Sonia Brischoux (S)

Service de pharmacie centrale, CHU Dupuytren, Limoges, France.

Julien Magne (J)

Department of Cardiology and CEBIMER, Limoges University Hospital, France; INSERM U1094, IRD U270, Univ. Limoges, CHU Limoges, EpiMaCT - Epidémiologie des maladies chroniques en zone tropicale, OmegaHealth, Institut d'Epidémiologie et de Neurologie Tropicale, Limoges, France.

Charbel Mounayer (C)

University Hospital of Limoges, Neuroradiology Department, 2 avenue Martin Luther-King, Dupuytren, Limoges 87042, France; University of Limoges, XLIM UMR CNRS, Limoges 7252, France.

Faraj Terro (F)

University of Limoges, XLIM UMR CNRS, Limoges 7252, France.

Aymeric Rouchaud (A)

University Hospital of Limoges, Neuroradiology Department, 2 avenue Martin Luther-King, Dupuytren, Limoges 87042, France; University of Limoges, XLIM UMR CNRS, Limoges 7252, France.

Classifications MeSH