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Szatmáry Z, Bardet SM, Mounier J, Janot K, Cortese J, Perrin ML, Couquet C, Deniau G, Hauquier F, Migneret R, Guenin E, Maire M, Michel JB, Forestier G, Le Flahec A, Leger-Bretou C, Mounayer C, Chaubet F, Rouchaud A. Fucoidan-coated coils improve healing in a rabbit elastase aneurysm model. J Neurointerv Surg 2024; 16:824-829. [PMID: 37491380 DOI: 10.1136/jnis-2023-020596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Accepted: 07/13/2023] [Indexed: 07/27/2023]
Abstract
BACKGROUND Recanalization of coiled aneurysms remains unresolved. To limit aneurysm recanalization after embolization with coils, we propose an innovative approach to optimize aneurysm healing using fucoidan-coated coils. OBJECTIVE To evaluate the short-term efficacy and long-term safety of the new coil system with conventional angiography, histology, and multiphoton microscopy for follow-up of fibrosis and neointima formation. METHODS We conducted a feasibility study on rabbit elastase-induced aneurysms. Embolization was carried out with bare platinum coils, fucoidan-coated coils, or dextran-coated coils. Aneurysms were controlled after 1 month by digital subtraction angiography (DSA). Aneurysm samples were collected and processed for histological analysis. Aneurysm healing and fibrosis were measured by quantifying collagen according to the histological healing score by combining standard light microscopy and multiphoton imaging. We divided 27 rabbits into three groups: bare platinum group, fucoidan group, and dextran group as controls. RESULTS Angiographic grading showed a trend toward less recanalization in the fucoidan group, although there were no significant differences among the three groups (P=0.21). Histological healing was significantly different according to the presence of more collagen in the neck area of aneurysms in the fucoidan group versus the bare platinum group (P=0.011), but not in the dextran group. Histological index was significantly better at the aneurysm neck in the fucoidan group than in the bare platinum group (P=0.004). Collagen organization index was also significantly better in the fucoidan group than in the bare platinum group (P=0.007). CONCLUSION This proof-of-concept study demonstrated the feasibility and efficacy of treatment with fucoidan-coated coils to improve aneurysm healing. The results in this rabbit in vivo model showed that fucoidan-coated coils have the potential to improve healing following endovascular treatment.
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Affiliation(s)
- Zoltán Szatmáry
- Department of Interventional Neuroradiology, Limoges University, Limoges, France
- CNRS, XLIM, UMR 7252, Limoges University, Limoges, France
| | | | - Jérémy Mounier
- CNRS, XLIM, UMR 7252, Limoges University, Limoges, France
| | - Kevin Janot
- CNRS, XLIM, UMR 7252, Limoges University, Limoges, France
- Department of Interventional Neuroradiology, CHRU Tours CPU, Tours, France
| | - Jonathan Cortese
- CNRS, XLIM, UMR 7252, Limoges University, Limoges, France
- Department of Interventional Neuroradiology-NEURI Brain Vascular Center APHP, Hospital Bicetre, Le Kremlin-Bicêtre, France
| | | | - Cladue Couquet
- CNRS, XLIM, UMR 7252, Limoges University, Limoges, France
| | - Guy Deniau
- UMR CEA, CNRS 3685, NIMBE, LICSEN, Paris-Saclay University, Gif-sur-Yvette, France
| | - Fanny Hauquier
- UMR CEA, CNRS 3685, NIMBE, LICSEN, Paris-Saclay University, Gif-sur-Yvette, France
- Department of Chemistry and Health and Life Sciences, CNAM, Paris, France
| | - Rodolphe Migneret
- INSERM, UMRS 1148, LVTS, Paris, France
- Institut Galilée, Sorbonne North Paris University, Villetaneuse, France
| | - Erwann Guenin
- Laboratoire TIMR, Centre de Recherche Royallieu Rue du Dr Schweitzer - CS 6031960200, Compiègne, France
| | - Murielle Maire
- INSERM, UMRS 1148, LVTS, Paris, France
- Institut Galilée, Sorbonne North Paris University, Villetaneuse, France
| | | | - Géraud Forestier
- Department of Interventional Neuroradiology, Limoges University, Limoges, France
- CNRS, XLIM, UMR 7252, Limoges University, Limoges, France
| | | | | | - Charbel Mounayer
- Department of Interventional Neuroradiology, Limoges University, Limoges, France
- CNRS, XLIM, UMR 7252, Limoges University, Limoges, France
| | - Frederic Chaubet
- INSERM, UMRS 1148, LVTS, Paris, France
- Institut Galilée, Sorbonne North Paris University, Villetaneuse, France
| | - Aymeric Rouchaud
- Department of Interventional Neuroradiology, Limoges University, Limoges, France
- CNRS, XLIM, UMR 7252, Limoges University, Limoges, France
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Paz C, Suárez E, Cabarcos A, Pinto SIS. Numerical Study of a Thrombus Migration Risk in Aneurysm After Coil Embolization in Patient Cases: FSI Modelling. Cardiovasc Eng Technol 2023; 14:544-559. [PMID: 37468797 PMCID: PMC10465652 DOI: 10.1007/s13239-023-00672-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Accepted: 07/03/2023] [Indexed: 07/21/2023]
Abstract
PURPOSE There are still many challenges for modelling a thrombus migration process in aneurysms. The main novelty of the present research lies in the modelling of aneurysm clot migration process in a realistic cerebral aneurysm, and the analysis of forces suffered by clots inside an aneurysm, through transient FSI simulations. METHODS The blood flow has been modelled using a Womersley velocity profile, and following the Carreau viscosity model. Hyperelastic Ogden model has been used for clot and isotropic linear elastic model for the artery walls. The FSI coupled model was implemented in ANSYS® software. The hemodynamic forces suffered by the clot have been quantified using eight different clot sizes and positions inside a real aneurysm. RESULTS The obtained results have shown that it is almost impossible for clots adjacent to aneurysm walls, to leave the aneurysm. Nevertheless, in clots positioned in the centre of the aneurysm, there is a real risk of clot migration. The risk of migration of a typical post-coiling intervention clot in an aneurysm, in contact with the wall and occupying a significant percentage of its volume is very low in the case studied, even in the presence of abnormally intense events, associated with sneezes or impacts. CONCLUSIONS The proposed methodology allows evaluating the clot migration risk, vital for evaluating the progress after endovascular interventions, it is a step forward in the personalized medicine, patient follow-up, and helping the medical team deciding the optimal treatment.
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Affiliation(s)
- C. Paz
- CINTECX, Universidade de Vigo, Campus As Lagoas-Marcosende, 36310 Vigo, Spain
| | - E. Suárez
- CINTECX, Universidade de Vigo, Campus As Lagoas-Marcosende, 36310 Vigo, Spain
| | - A. Cabarcos
- CINTECX, Universidade de Vigo, Campus As Lagoas-Marcosende, 36310 Vigo, Spain
| | - S. I. S. Pinto
- Engineering Faculty of University of Porto, Institute of Science and Innovation in Mechanical and Industrial Engineering (LAETA-INEGI), Rua Dr. Roberto Frias, 4200-465 Porto, Portugal
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Zoltan S, Jonathan C, Jeremy M, Marie-Laure P, Kevin J, Claude C, Le Flahec A, Claire LB, Charbel M, Aymeric R, Bardet SM. A novel histological occlusion classification for coiled aneurysms based on multiphoton microscopy. Interv Neuroradiol 2023:15910199231157926. [PMID: 36803150 DOI: 10.1177/15910199231157926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/22/2023] Open
Abstract
OBJECTIVE Intracranial aneurysm (IA) coiling remains the most commonly used endovascular approach for ruptured and unruptured IA, and recanalization is a common drawback that impairs treatment success. Angiographic occlusion and aneurysm healing are not synonymous, and histological evaluation of embolized aneurysms remains a challenge. We propose here an experimental study of coil embolization in animal models by multiphoton microscopy (MPM) in comparison with conventional histological staining. The purpose of his work is to analyze coil healing process using histological sections of aneurysms. METHODS Based on a rabbit elastase model, 27 aneurysms were fixed, embedded in resin, and cut in thin histological sections 1 month after coils implantation and after angiographic control. Hematoxylin and eosin (H&S) staining were realized. Non-stained adjacent slices were imaged for multiphoton excited autofluorescence (AF) and second-harmonic generation (SHG) to construct three-dimensional (3D) projections of sequentially and axially acquired images. RESULTS The contrast provided by the combination of these two imaging modalities can be used to distinguish five levels of aneurysm healing, based on a combination of thrombus evolution and increased extracellular matrix (ECM) deposit. CONCLUSION RDPC:\Users\SHAHUL\RDP6|We have established a novel histological scale from a rabbit elastase aneurysm model after coiling with a classification of five different stages thanks to nonlinear microscopy. This classification is an actualized tool in order to obtain a more precise evaluation of occlusion device efficacy in the scope of new innovative microscopy for research.
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Affiliation(s)
- Szatmary Zoltan
- Neuroradiology Department, 27025Limoges University, Dupuytren Hospital, Limoges, France
- XLIM UMR CNRS 7252 Limoges, Aquitaine, France
| | - Cortese Jonathan
- XLIM UMR CNRS 7252 Limoges, Aquitaine, France
- Neuroradiology Department, Hôpital Bicêtre Interventional, Le Kremlin Bicêtre, Ile-de-France, France
| | - Mounier Jeremy
- XLIM UMR CNRS 7252 Limoges, Aquitaine, France
- 27025Medical Faculty, Limoges University, Limoges, France
| | | | - Janot Kevin
- XLIM UMR CNRS 7252 Limoges, Aquitaine, France
- Neuroradiology Department, University Hospital of Tours, Tours, France
| | - Couquet Claude
- 27025Medical Faculty, Limoges University, Limoges, France
| | | | | | - Mounayer Charbel
- Neuroradiology Department, 27025Limoges University, Dupuytren Hospital, Limoges, France
- XLIM UMR CNRS 7252 Limoges, Aquitaine, France
| | - Rouchaud Aymeric
- Neuroradiology Department, 27025Limoges University, Dupuytren Hospital, Limoges, France
- XLIM UMR CNRS 7252 Limoges, Aquitaine, France
| | - Sylvia M Bardet
- XLIM UMR CNRS 7252 Limoges, Aquitaine, France
- 27025Medical Faculty, Limoges University, Limoges, France
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Clinical Usage of Different Doses of Cis-Atracurium in Intracranial Aneurysm Surgery and Its Effect on Motor-Evoked Potentials. COMPUTATIONAL AND MATHEMATICAL METHODS IN MEDICINE 2022; 2022:5910019. [PMID: 35799657 PMCID: PMC9256351 DOI: 10.1155/2022/5910019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Revised: 05/24/2022] [Accepted: 05/26/2022] [Indexed: 11/17/2022]
Abstract
The objective of this work was to investigate the effect of different doses of cis-atracurium on patients undergoing general anesthesia induction (GAI) during intracranial aneurysm surgery (ICAS). In this work, 90 patients who underwent ICAS under the elective motor-evoked potential (MEP) monitoring in the First Affiliated Hospital of Northwest University (Xi'an No. 1 Hospital) from January 2021 to May 2022 were enrolled as the research objects. Randomly, they were rolled into a S1 group (30 cases, 2 times 95% effective dose (ED95) cis-atracurium), a S2 group (30 cases, 3 times ED95 cis-atracurium), and a S3 group (30 cases, 4 times ED95 cis-atracurium). The endotracheal intubation conditions, the train-of-four (TOF) rate (TOFR), body movement, and spontaneous breathing were compared among the three groups of patients. The results showed that the MEP inhibition time of the patients in the S3 group was much longer than that of the S1 and S2 groups, but it showed no significant difference between the S1 group and S2 group (P > 0.05). The good rates of endotracheal intubation conditions in the S2 group (100%) and S3 group (100%) were obviously higher than the rate in the S1 group (43.33%). The TOFRs of patients in S2 and S3 groups at time t2 and t3 were lower obviously to that at time t0, while the TOFRs of patients in S3 group at time t2 and t3 were still lower in contrast to the S2 group (P < 0.05). The mean arterial pressure (MAP) and heart rate (HR) of patients in all groups were lower at t1, t2, and t3 than at t0 (P < 0.05), while the differences among different groups were not remarkable (P > 0.05). Finally, using 3 times ED95 cis-atracurium for GAI could reduce the risk of intraoperative body movement and spontaneous breathing, as well as the residual degree of muscle relaxation, in patients with ICAS, without affecting MEP monitoring, improving endotracheal intubation conditions, and increasing safety during open neurosurgery operations.
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