Treatment of Ruptured Wide-Necked Aneurysms using a Microcatheter Injectable Biomaterial.

Area of Science:

• Biomaterials Science
• Interventional Neuroradiology
• Vascular Surgery

Background:

• Ruptured wide-neck aneurysms (WNAs) pose significant risks, especially with coagulopathy.
• Current treatments for ruptured WNAs have limitations, leading to high morbidity and mortality.
• Catastrophic bleeding from ruptured WNAs requires immediate and effective hemostatic solutions.

Purpose of the Study:

• To develop and evaluate a novel catheter-injectable gel embolic agent (GEA) for treating ruptured WNAs.
• To assess the efficacy of a combinatorial approach using GEA and flow diverter stents (FDS) in large-animal models.
• To compare the performance of the novel GEA against a clinically used liquid embolic agent.

Main Methods:

• Development and in vitro optimization of a biomaterial comprising gelatin, nanoclay, and iohexol.
• In vivo testing of the GEA in murine, porcine, and canine models of WNAs, including ruptured cases.
• Utilizing a flow diverter stent (FDS) to trap a catheter within the aneurysm sac for GEA delivery.

Main Results:

• The optimized GEA demonstrated effective hemostasis and outperformed control groups in animal models.
• The GEA, delivered via a catheter and FDS, successfully rescued catastrophic bleeding in ruptured WNA models.
• The novel GEA showed superior results compared to a clinically used liquid embolic agent (Onyx).

Conclusions:

• A combinatorial approach using GEA and FDS offers a promising new strategy for treating ruptured WNAs.
• This novel biomaterial-based embolic agent has the potential to improve outcomes and save lives.
• Further clinical translation of this approach could significantly advance the standard of care for complex aneurysms.