Multiphoton microscopy for pre-clinical evaluation of flow-diverter stents for treating aneurysms

Comparison of arterial wall integration of different flow diverters in rabbits: The CICAFLOW study

BACKGROUND AND PURPOSE

New coated flow diverters (FDs) claim antithrombotic properties and increased arterial wall integration. The aim of this study is to compare in vivo endothelial coverage of coated and uncoated FD in the context of different antiplatelet regimens.

METHODS

Different FDs (Silk Vista - SV, Pipeline with Shield technology - PED shield and Surpass Evolve - SE) were implanted in the aorta of rabbits, all 3 in each animal with 3 different antiplatelet regimens: no antiplatelet therapy, aspirin alone, or aspirin and ticagrelor. Four weeks after FD implantation, angiography, flat-panel CT, and optical coherence tomography (OCT) were performed before harvesting the aorta. Extensive histopathology analyses were performed including environmental scanning electron microscopy (ESEM), multiphoton microscopy (MPM) and histological staining with qualitative and/or quantitative assessment of device coverage.

RESULTS

All 23 FDs that were implanted remained patent without hyperplasia. Qualitative stent coverage assessment revealed that there were no statistically significant differences between the FD groups (p = 0.19, p = 0.45, p = 0.40, and p = 0.84 for OCT, ESEM, MPM and histology, respectively). Quantitative neointimal measurement of histological sections also showed similar results in all 3 FD groups (p = 0.70). However, there were significant differences between the 3 groups of antiplatelet regimens (p = 0.07) with a higher rate in the no antiplatelet group (p = 0.05 versus aspirin alone and p = 0.03 versus aspirin and ticagrelor).

CONCLUSION

Our study provides evidence that FD integration into the arterial wall is similar with coated (PED shield) and uncoated devices (SV, SE), regardless of the antiplatelet regimen. FD integration with specific surface coverage should be promoted.

TRIAL REGISTRATION

APAFIS #2022011215518538.

A novel histological occlusion classification for coiled aneurysms based on multiphoton microscopy

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.

10 ns PEFs induce a histological response linked to cell death and cytotoxic T-lymphocytes in an immunocompetent mouse model of peritoneal metastasis

PURPOSE

The application of nanosecond pulsed electric fields (nsPEFs) could be an effective therapeutic strategy for peritoneal metastasis (PM) from colorectal cancer (CRC). The aim of this study was to evaluate in vitro the sensitivity of CT-26 CRC cells to nsPEFs in combination with chemotherapeutic agents, and to observe the subsequent in vivo histologic response.

METHODS

In vitro cellular assays were performed to assess the effects of exposure to 1, 10, 100, 500 and 1000 10 ns pulses in a cuvette or bi-electrode system at 10 and 200 Hz. nsPEF treatment was applied alone or in combination with oxaliplatin and mitomycin. Cell death was detected by flow cytometry, and permeabilization and intracellular calcium levels by fluorescent confocal microscopy after treatment. A mouse model of PM was used to investigate the effects of in vivo exposure to pulses delivered using a bi-electrode system; morphological changes in mitochondria were assessed by electron microscopy. Fibrosis was measured by multiphoton microscopy, while the histological response (HR; hematoxylin-eosin-safran stain), proliferation (KI67, DAPI), and expression of immunological factors (CD3, CD4, CD8) were evaluated by classic histology.

RESULTS

10 ns PEFs exerted a dose-dependent effect on CT-26 cells in vitro and in vivo, by inducing cell death and altering mitochondrial morphology after plasma membrane permeabilization. In vivo results indicated a specific CD8+ T cell immune response, together with a strong HR according to the Peritoneal Regression Grading Score (PRGS).

CONCLUSIONS

The effects of nsPEFs on CT-26 were confirmed in a mouse model of CRC with PM.