Abstract
After coil embolization, recanalization in cerebral aneurysms adversely influences long-term prognosis. Proliferation of endothelial cells on the coil surface may reduce the incidence of recanalization and further improve outcomes after coil embolization. We aimed to map the expression of proliferating tissue over the aneurysmal orifice and define the temporal profile of tissue growth in a swine experimental aneurysm model. We compared the outcomes after spontaneous thrombosis with those of coil embolization using histological and morphological techniques. In aneurysms that we not coiled, spontaneous thrombosis was observed, and weak, easily detachable proliferating tissue was evident in the aneurysmal neck. In contrast, in the coil embolization group, histological analysis showed endothelial-like cells lining the aneurysmal opening. Moreover, immunohistochemical and morphological analysis suggested that these cells were immature endothelial cells. Our results indicated the existence of endothelial cell proliferation 1 week after coil embolization and showed immature endothelial cells in septal tissue between the systemic circulation and the aneurysm. These findings suggest that endothelial cells are lead to and proliferate in the former aneurysmal orifice. This is the first examination to evaluate the temporal change of proliferating tissue in a swine experimental aneurysm model.
Highlights
Endovascular detachable coil treatment of intracranial aneurysms is an effective and increasingly popular non-invasive alternative to surgical clipping
In patients with ruptured intracranial aneurysms, endovascular intervention with detachable platinum coils can improve the chances of independent survival compared with neurosurgical intervention to clip the neck of the aneurysm [1,2,3]
We examined the expression profile of proliferating tissue covering the aneurysmal orifice using histochemical and morphological techniques in a swine model of sidewall-type cerebral aneurysm after coil embolization and spontaneous thrombosis
Summary
Endovascular detachable coil treatment of intracranial aneurysms is an effective and increasingly popular non-invasive alternative to surgical clipping. In patients with ruptured intracranial aneurysms, endovascular intervention with detachable platinum coils can improve the chances of independent survival compared with neurosurgical intervention to clip the neck of the aneurysm [1,2,3]. When compared with surgical clipping, endovascular therapy of unruptured aneurysms is associated with decreased risk of adverse outcomes and in-hospital death, lower hospital charges, and shorter hospital stays [4]. The indications for and popularity of endovascular therapy is expected to increase further as better devices are developed. Recanalization should be avoided, as there is a high risk of aneurysmal rupture after endovascular therapy
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