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Analysis of neointima development in flow diverters using optical coherence tomography imaging
Yoshikazu Matsuda1,2, Joonho Chung1,3, Demetrius K Lopes1
1Department of Neurological Surgery, Rush University Medical Center, Chicago, Illinois, USA.
Surface modification of flow diverters may impact neointima formation. The Pipeline Embolization Device (PED) with Shield technology showed a trend towards earlier endothelialization and more concentric neointima compared to standard devices in a swine model.
Area of Science:
- Biomedical engineering
- Vascular surgery
- Medical imaging
Background:
- Flow diverters treat intracranial aneurysms.
- Surface modification may reduce thrombogenicity, but data is limited.
- Optical coherence tomography (OCT) visualizes neointimal growth over stents.
Purpose of the Study:
- Compare neointima development on flow diverters and stents with/without surface modification.
- Evaluate the impact of Pipeline Embolization Device (PED) Shield technology.
- Utilize intravascular OCT for in vivo analysis.
Main Methods:
- Implanted PED Flex, PED Shield, and Solitaire devices in swine carotid arteries.
- Acquired serial angiographic and OCT images over 21 days.
- Analyzed neointimal area, ratio, and thickness.
Main Results:
- No significant difference in neointima initiation site.
- PED Shield showed a trend towards earlier endothelial formation at day 7.
- By day 21, PED Flex and PED Shield had higher neointimal ratios than Solitaire.
- PED Shield exhibited a significantly higher neointimal thickness ratio than PED Flex and Solitaire.
Conclusions:
- OCT effectively monitored in vivo neointima development over implants.
- PED Shield demonstrated comparable neointimal volume to PED Flex.
- PED Shield promoted more concentric neointima formation.
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