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AJNR - American Journal of Neuroradiology

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Development of the Biologically Active Guglielmi Detachable Coil for the Treatment of Cerebral Aneurysms. Part II: An Experimental Study in a Swine Aneurysm Model

Yuichi Murayama^,a, Fernando Viñuela^a, Yoshiaki Suzuki^a, Yoichi Akiba^a, Alex Ulihoa^a, Gary R. Duckwiler^a, Y. Pierre Gobin^a, Harry V. Vinters^a, Masaya Iwaki^a and Toshiaki Abe^a

^a From the Division of Interventional Neuroradiology, Leo G. Rigler Radiological Research Center (Y.M., F.V., Y.A., A.U., G.R.D., Y.P.G.), and Division of Neuropathology (H.V.V.), University of California, Los Angeles, School of Medicine; Department of Neurosurgery (Y.M., T.A., Y.A.), the Jikei University School of Medicine, Tokyo Japan; and The Institute of Physical and Chemical Research (Y.S., M.I.), Wako, Saitama, Japan.

View larger version (288K): [in a new window]   FIG 1. Scanning electron-microscopic appearances of surface of a standard coil (A) and a protein-coated ion-implanted coil (B) (original magnification, x1500). Note crater-like appearance of ion-beam bombardment on protein-coated coil surface.

View larger version (102K): [in a new window]   FIG 2. Angiograms of experimental aneurysms created on right and left common carotid arteries (A and B) and occluded aneurysms after standard GDC treatment (C, left) and protein coated GDC-I (D, right). Note tight packing of both aneurysms.

View larger version (148K): [in a new window]   FIG 3. Macroscopic appearances of an aneurysmal orifice 14 days after treatment, with standard GDC (A) and collagen GDC-I (B). Surfaces of standard GDCs were covered with fibrin-like materials. On the other hand, the orifice of collagen GDC-I treated aneurysm was covered completely with thick fibrous tissue.

View larger version (53K): [in a new window]   FIG 4. Neck coverage ratios for treated aneurysms at day 14. Largest dimensions of the orifice (OF) of the aneurysm and the fibrous membrane (FM) that covers the orifice were recorded and calculated as FM/OF proportion (fibrous membrane/ length of orifice x 100%). Standard GDC (n = 23), 48.3% ± 20.5%; collagen GDC-I (n = 11), 89.4% ± 14.9%; vitronectin GDC-I (n = 6), 71.5% ± 7.0%; laminin GDC-I (n = 4), 76.5% ± 11.0%; fibrinogen GDC-I, 74.8% ± 13.9% (n = 6); fibronectin GDC-I (n = 6), 87.5% ± 15.0%.

View larger version (195K): [in a new window]   FIG 5. Light microscopic findings in region of aneurysm neck at day 14 after treatment, with standard GDCs (A, original magnification) or vitronectin GDC-Is (B, x10). Note intense fibroblast response with vitronectin GDC-I. Only a thin fibrous layer was observed with standard GDCs. Light microscopic findings in region of the aneurysm sac. Sac of aneurysm treated with collagen GDC-I was filled with fibroblasts and monocytes. No neovascularization was seen with collagen GDC-Is (C, x10), whereas microscopic neovascularization was seen in aneurysmal dome with standard GDCs (arrow, D, x10).

View larger version (212K): [in a new window]   FIG 6. Scanning electron microscopic appearance of orifice of embolized aneurysms. A and B, Lower (x20) and higher (x250) magnification of orifice treated with standard GDCs. Surface of coils were exposed to the arterial lumen and only fibrin/leukocyte complex was seen on surface. C and D, Lower (x23) and higher (x100) magnification of orifice treated with laminin GDC-Is. Orifice was covered completely with neoendothelial cell layer.