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Endovascular treatment of unruptured intracranial aneurysms and circulating endothelial cells

Jean-François Vendrell1, Renaud Cezar, Nils Kuster

  • 1Department of Neuroradiology, University Hospital Center, Guy de Chauliac Hospital, 80 Avenue Augustin Fliche, 34295 Montpellier Cedex, France. jfvendrell@yahoo.fr

European Journal of Radiology
|December 21, 2012
PubMed

Insights

Endovascular treatment (EVT) of brain aneurysms releases circulating endothelial cells (CECs), potentially causing silent ischemic brain lesions. Monitoring CECs may help optimize EVT and reduce complications.

Area of Science:

  • Neuroendovascular research
  • Vascular biology
  • Medical device technology

Background:

  • Endovascular treatment (EVT) is a common procedure for unruptured intracranial aneurysms.
  • Complications, such as silent ischemic brain lesions, can occur despite successful treatment.
  • Circulating endothelial cells (CECs) are shed from damaged blood vessel walls.

Purpose of the Study:

  • To investigate the role of CECs in complications following EVT for intracranial aneurysms.
  • To characterize and quantify CECs in different blood compartments before and after EVT.
  • To correlate CEC levels with the occurrence of ischemic brain events.

Main Methods:

  • CECs were identified and counted using the CellTracks(®) System in blood samples from the femoral artery, internal carotid artery (before and after EVT), and peripheral veins (before and after EVT).
  • Patients (n=15) underwent diffusion-weighted imaging (DWI-MRI) to assess ischemic brain lesions before and 24 hours after EVT.
  • CEC characterization involved markers CD146, CD105, CD45, and DAPI.

Main Results:

  • Higher numbers of single CECs and clusters were found in the internal carotid artery (ICA) before EVT compared to other sampling sites.
  • Large CEC clusters were predominantly observed in the ICA, suggesting device-induced endothelial injury.
  • Silent ischemic brain lesions were detected in 60% (9/15) of patients, despite uneventful clinical recovery.

Conclusions:

  • EVT procedures can lead to the detachment of CECs from arterial walls, potentially contributing to the formation of silent ischemic brain lesions.
  • Quantifying CECs alongside DWI-MRI may offer a valuable method for monitoring EVT outcomes and refining endovascular device strategies.
  • This approach could help minimize EVT-related complications.
Abstract

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