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Kim S, Nowicki KW, Gross BA, Wagner WR. Injectable hydrogels for vascular embolization and cell delivery: The potential for advances in cerebral aneurysm treatment. Biomaterials 2021; 277:121109. [PMID: 34530233 DOI: 10.1016/j.biomaterials.2021.121109] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Revised: 08/23/2021] [Accepted: 08/27/2021] [Indexed: 12/11/2022]
Abstract
Cerebral aneurysms are vascular lesions caused by the biomechanical failure of the vessel wall due to hemodynamic stress and inflammation. Aneurysmal rupture results in subarachnoid hemorrhage often leading to death or disability. Current treatment options include open surgery and minimally invasive endovascular options aimed at secluding the aneurysm from the circulation. Cerebral aneurysm embolization with appropriate materials is a therapeutic approach to prevent rupture and the resultant clinical sequelae. Metallic platinum coils are a typical, practical option to embolize cerebral aneurysms. However, the development of an alternative treatment modality is of interest because of poor occlusion permanence, coil migration, and coil compaction. Moreover, minimizing the implanted foreign materials during therapy is of importance not just to patients, but also to clinicians in the event an open surgical approach has to be pursued in the future. Polymeric injectable hydrogels have been investigated for transcatheter embolization and cell therapy with the potential for permanent aneurysm repair. This review focuses on how the combination of injectable embolic biomaterials and cell therapy may achieve minimally invasive remodeling of a degenerated cerebral artery with promise for superior outcomes in treatment of this devastating disease.
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Affiliation(s)
- Seungil Kim
- McGowan Institute for Regenerative Medicine, University of Pittsburgh, Pittsburgh, PA, USA; Department of Surgery, University of Pittsburgh, Pittsburgh, PA, USA
| | - Kamil W Nowicki
- Department of Neurosurgery, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - Bradley A Gross
- Department of Neurosurgery, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - William R Wagner
- McGowan Institute for Regenerative Medicine, University of Pittsburgh, Pittsburgh, PA, USA; Department of Surgery, University of Pittsburgh, Pittsburgh, PA, USA; Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, USA; Department of Chemical and Petroleum Engineering, University of Pittsburgh, Pittsburgh, PA, USA.
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Gao Y, Lu Z, Chen C, Cui X, Liu Y, Zheng T, Jiang X, Zeng C, Quan D, Wang Q. Mesenchymal stem cells and endothelial progenitor cells accelerate intra-aneurysmal tissue organization after treatment with SDF-1α-coated coils. Neurol Res 2016; 38:333-41. [PMID: 27125512 DOI: 10.1080/01616412.2016.1164433] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Recurrences of aneurysms remain the major drawback of detachable coils for the endovascular treatment of intracranial aneurysms. The aim of the present study is to develop new modified coils, coating the surface of platinum coils with silk fibroin (SF) consisting of stromal cell-derived factor-1α (SDF-1α), and evaluate its acceleration of organization of cavities and reduction of lumen size in a rat aneurysm model. The morphological characteristics of SDF-1α-coated coils were examined using scanning electron microscopy (SEM). Fifty experimental aneurysms were created and randomly divided into five groups: three groups were embolized with SDF-1α-coated coils (8 mm) and two of these groups need transplantation of mesenchymal stem cells (MSCs) or endothelial progenitor cells (EPCs); one group was embolized with bare coils (8 mm) and another group severed as control. After coil implantation for 14 or 28 days, the coils were harvested and histological analysis was performed. SEM photographs showed that SF/SDF-1α-coated coils have uniform size and a thin film compared with bare coils. In the group treated with SDF-1α-coated coils, tissue organization was accelerated and the proliferation of α-smooth muscle actin positive cells was promoted in the aneurysmal sac. Compared with unmodified coils, on day 28, tissue organization was significantly greater in the group treated with SDF-1α-coated coils and MSC or EPC transplantation. These results suggest that SDF-1α-coated coils with MSC or EPC transplantation may be beneficial in the aneurysm healing and endothelialization at the orifice of embolized aneurysm.
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Affiliation(s)
- Yuyuan Gao
- a The National Key Clinical Specialty, The Engineering Technology Research Center of Education Ministry of China, Guangdong Provincial Key Laboratory on Brain Function Repair and Regeneration, Department of Neurosurgery, Zhujiang Hospital , Southern Medical University , Guangzhou , China.,b Graduate School of Southern Medical University , Guangzhou , China.,c Department of Neurology , Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangdong Neuroscience Institute , Guangzhou , China
| | - Ziming Lu
- a The National Key Clinical Specialty, The Engineering Technology Research Center of Education Ministry of China, Guangdong Provincial Key Laboratory on Brain Function Repair and Regeneration, Department of Neurosurgery, Zhujiang Hospital , Southern Medical University , Guangzhou , China.,b Graduate School of Southern Medical University , Guangzhou , China
| | - Chengwei Chen
- a The National Key Clinical Specialty, The Engineering Technology Research Center of Education Ministry of China, Guangdong Provincial Key Laboratory on Brain Function Repair and Regeneration, Department of Neurosurgery, Zhujiang Hospital , Southern Medical University , Guangzhou , China.,b Graduate School of Southern Medical University , Guangzhou , China
| | - Xubo Cui
- a The National Key Clinical Specialty, The Engineering Technology Research Center of Education Ministry of China, Guangdong Provincial Key Laboratory on Brain Function Repair and Regeneration, Department of Neurosurgery, Zhujiang Hospital , Southern Medical University , Guangzhou , China.,b Graduate School of Southern Medical University , Guangzhou , China
| | - Yaqi Liu
- a The National Key Clinical Specialty, The Engineering Technology Research Center of Education Ministry of China, Guangdong Provincial Key Laboratory on Brain Function Repair and Regeneration, Department of Neurosurgery, Zhujiang Hospital , Southern Medical University , Guangzhou , China.,b Graduate School of Southern Medical University , Guangzhou , China
| | - Tao Zheng
- a The National Key Clinical Specialty, The Engineering Technology Research Center of Education Ministry of China, Guangdong Provincial Key Laboratory on Brain Function Repair and Regeneration, Department of Neurosurgery, Zhujiang Hospital , Southern Medical University , Guangzhou , China.,b Graduate School of Southern Medical University , Guangzhou , China
| | - Xiaodan Jiang
- a The National Key Clinical Specialty, The Engineering Technology Research Center of Education Ministry of China, Guangdong Provincial Key Laboratory on Brain Function Repair and Regeneration, Department of Neurosurgery, Zhujiang Hospital , Southern Medical University , Guangzhou , China
| | - Chi Zeng
- d School of Chemistry and Chemical Engineering , Sun Yat-Sen University , Guangzhou , China
| | - Daping Quan
- d School of Chemistry and Chemical Engineering , Sun Yat-Sen University , Guangzhou , China
| | - Qiujing Wang
- a The National Key Clinical Specialty, The Engineering Technology Research Center of Education Ministry of China, Guangdong Provincial Key Laboratory on Brain Function Repair and Regeneration, Department of Neurosurgery, Zhujiang Hospital , Southern Medical University , Guangzhou , China
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Wang Q, Gao Y, Sun X, Ji B, Cui X, Liu Y, Zheng T, Chen C, Jiang X, Zhu A, Quan D. Acceleration of aneurysm healing by P(DLLA-co-TMC)-coated coils enabling the controlled release of vascular endothelial growth factor. Biomed Mater 2014; 9:045004. [PMID: 24945939 DOI: 10.1088/1748-6041/9/4/045004] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Since the introduction of the detachable coil in endovascular treatment of intracranial aneurysms, the in-hospital mortality rate has been significantly decreased. Recurrence of the aneurysm remains the major drawback of using detachable coils. We prepared a bioactive coil coated with poly(d,l-lactide)-7co-(1,3-trimethylene carbonate) (P(DLLA-co-TMC)), a novel copolymer for controlling the release of vascular endothelial growth factor (VEGF). Platinum coils were prepared by successive coating with cationic P(DLLA-co-TMC) and anionic heparin. Then, recombinant human VEGF-165 (rhVEGF) was immobilized by affinity binding to heparin. The morphological characteristics and sustained in vitro release of rhVEGF were examined using scanning electron microscopy and enzyme-linked immunosorbent assay, respectively. The efficacy of these novel coils modified by P(DLLA-co-TMC)/rhVEGF was tested using a common carotid artery aneurysm model in rats. Experimental aneurysms were embolized with unmodified, P(DLLA-co-TMC)/heparin-coated or P(DLLA-co-TMC)/rhVEGF-coated platinum coils (n = 18). The coils were removed on days 15, 30 and 90 after insertion, and the histological and immunohistochemical analysis of factor VIII was performed to confirm the presence of endothelial cells in the organized area. In addition, the controlled in vivo release of VEGF was confirmed by Western blotting analysis. The release of VEGF tended to increase during the whole period and no burst release was observed. In the group treated with P(DLLA-co-TMC)/rhVEGF-coated platinum coils, clot organization and endothelial cell proliferation were accelerated. The immunohistochemistry study showed that the expression of factor VIII was found in the P(DLLA-co-TMC)/rhVEGF-coated coil group but not in the other two groups. Furthermore, Western blotting analysis confirmed that the major released VEGF in the aneurysm sac was from the P(DLLA-co-TMC)/VEGF-coated coil. P(DLLA-co-TMC)/rhVEGF-coated platinum coils can promote clot organization and endothelial cell proliferation in a rat aneurysm model.
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Affiliation(s)
- Qiujing Wang
- Department of Neurosurgery, Zhujiang Hospital, The National Key Clinic Specialty, The Neurosurgery Institute of Guangdong Province, Guangdong Provincial Key Laboratory on Brain Function Repair and Regeneration, Southern Medical University, Guangzhou 510282, Guangdong Province, People's Republic of China
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