Covered stent placement for artificial cervical carotid aneurysms. Experimental study

Area of Science:

• Vascular Surgery
• Interventional Cardiology
• Biomaterials Science

Background:

• Cervical carotid aneurysms pose a significant risk of stroke.
• Endovascular techniques are increasingly explored for aneurysm treatment.
• Dacron-covered self-expanding metallic stents offer a potential solution for aneurysm occlusion.

Purpose of the Study:

• To evaluate the midterm patency and effectiveness of Dacron-covered self-expanding metallic stents.
• To assess the safety and efficacy of these stents in treating wide-necked carotid aneurysms in a canine model.

Main Methods:

• Wide-necked carotid aneurysms were surgically created in dogs using vein pouch end-to-side anastomosis.
• Dacron-covered self-expanding metallic stents were implanted percutaneously to occlude the aneurysms.
• Angiographic follow-up was conducted for 3 months with anticoagulation and antiplatelet therapy.

Main Results:

• Stent implantation led to rapid angiographic disappearance of aneurysms.
• Acute thrombotic obstruction occurred in one of five cases.
• Delayed stenosis was observed in two of five cases within two weeks.
• Only one of five aneurysms remained patent without stenosis at 3 months.
• No histological evidence of cerebral infarction was found.

Conclusions:

• Dacron-covered stents can achieve rapid occlusion of wide-necked carotid aneurysms.
• The short- to midterm patency of these stents was poor.
• Current Dacron-covered stent materials are not sufficiently safe for clinical application in carotid lesions.
• Further research is needed to improve stent materials before clinical use.