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Journal of neurosurgery · Dec 2022
Immediate flow-diversion characteristics of a novel primarily bioresorbable flow-diverting stent.
- Sandeep Muram, Ronan Corcoran, Jillian Cooke, Kendall Forrester, Elana Lapins, Rosalie Morrish, Osama Zahoor Ahmad Cheema, Mayank Goyal, Muneer Eesa, David Fiorella, John H Wong, Chander Sadasivan, and Alim P Mitha.
- 1Department of Clinical Neurosciences, University of Calgary.
- J. Neurosurg. 2022 Dec 1; 137 (6): 179418001794-1800.
ObjectiveFlow-diverting stents with a resorbable component have significant theoretical benefits over full metal stents, although currently there are none in clinical use. In this study, the authors sought to determine the immediate flow-diversion characteristics of a novel primarily bioresorbable flow-diverting stent.MethodsBioresorbable stents were deployed into glass tube models to determine porosity and pore density. In vitro flow diversion behavior was evaluated using high frame rate angiography under pulsatile flow conditions in a patient-specific silicone aneurysm model treated with the resorbable stent as well as the Surpass Evolve stent. In vivo flow diversion was characterized by deployment into 20 rabbit saccular aneurysm models, and grading was based on the O'Kelly-Marotta scale and the 4F-flow diversion predictive score.ResultsPorosities and pore densities of the bioresorbable stent were in the flow-diverting range for all target vessel diameters. Quantified results of immediate angiography after placement of the bioresorbable stent into a silicone aneurysm model demonstrated greater flow diversion compared to the Evolve stent. Bioresorbable stent placement in saccular aneurysm models resulted in an immediate O'Kelly-Marotta grade of A3 or better and a 4F-flow diversion predictive score of 4 or better in all cases.ConclusionsThe bioresorbable stent has immediate flow-diversion characteristics that are comparable to commercially available metal stents. Longer-term studies are underway to determine the ability of the resorbable fibers to act as a neointimal scaffold and result in long-term aneurysm occlusion.
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