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Longitudinal healing flow diverting stents with phosphorylcholine surface modification.
Christopher T Zoppo1, Mark Epshtein1, Matthew J Gounis2
1New England Center for Stroke Research, Department of Radiology, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA.
Journal of Neurointerventional Surgery
|July 4, 2023
Summary
Flow diverter surface modifications, like Shield, do not impact tissue growth or endothelialization in rabbit arteries. This finding suggests these devices promote similar healing in vivo, addressing concerns about delayed endothelialization.
Area of Science:
- Biomaterials Science
- Medical Devices
- Vascular Surgery
Background:
- Flow diversion is a standard treatment for cerebral aneurysms, but requires dual antiplatelet therapy and has delayed occlusion.
- Biomimetic phosphorylcholine polymer (Shield) modifications reduce thrombogenicity but may delay endothelialization.
- Concerns exist regarding the impact of Shield modifications on flow diverter endothelialization.
Purpose of the Study:
- To evaluate the in vivo effect of Shield surface modification and Vantage device design on flow diverter healing.
- To assess tissue growth and endothelialization in flow diverters with and without Shield modification.
Main Methods:
- Pipeline, Pipeline Shield, and Vantage with Shield devices were implanted in rabbit common carotid arteries.
- High-frequency optical coherence tomography and angiography were used for imaging at multiple time points.
- Scanning electron microscopy assessed endothelial growth at 30 days.
Main Results:
- No significant difference in average tissue growth thickness (ATGT) was observed between the three device types.
- Neointima formation was present by day 5, with similar ATGT across all devices.
- Scanning electron microscopy revealed no difference in endothelial scores between the device types.
Conclusions:
- In vivo, the Shield surface modification did not alter longitudinal healing of the flow diverter.
- The Vantage device design also did not impact the healing response.
- These findings suggest that Shield modification and Vantage design do not impede in vivo flow diverter healing.
