Large, Wide-Neck, Side-Wall Aneurysm Treatment in Canines Using NeuroCURE: A Novel Liquid Embolic.

IF 2.1 Q3 CLINICAL NEUROLOGY Stroke (Hoboken, N.J.) Pub Date : 2023-09-01 DOI:10.1161/svin.123.000857
William C Merritt, Nicholas Norris, Sophia Robertson, Mark C Preul, Andrew F Ducruet, Timothy A Becker
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Abstract

Background: Untreated intracranial aneurysms can rupture and result in high rates of morbidity and mortality. Although there are numerous approved endovascular aneurysm treatment devices, most require dual anti-platelet therapy, are minimally biocompatible, or are prone to recanalization. Neurovascular Controlled Uniform Rapid Embolic (NeuroCURE) is an innovative polymer gel material with long-term stability, biocompatibility, and hemocompatibility developed for the treatment of large, wide-neck aneurysms.

Methods: Sidewall aneurysms were surgically created in 10 canines and NeuroCURE was injected through a 0.025 microcatheter under a single balloon inflation period. Aneurysm treatment was angiographically assessed post-embolization and pre-term with Raymond-Roy occlusion classification and a qualitative flow grade scale. Aneurysm neck stability and biocompatibility was histologically assessed to grade platelet/fibrin thrombus, percent endothelialization, and neointimal formation. Aneurysm sac stability was assessed by NeuroCURE sac content, inflammation, and neo-angiogenesis scales.

Results: Explanted aneurysms exhibited a smooth surface at the aneurysm neck with nearly complete neointimal coverage at 3-months. By 6-months, neck endothelialization was 100% in all animals (average Raymond-Roy occlusion classification of 1.2), with no instances of aneurysm recanalization or parent vessel flow compromise. Biocompatibility assessments verified a lack of inflammatory response, neo-angiogenesis, and platelet/fibrin thrombus formation.

Conclusion: The NeuroCURE material promotes progressive occlusion of wide-necked side wall aneurysms over time without the need for dual antiplatelet agents. NeuroCURE also promotes neointimal tissue infill without dependence on thrombus formation and thus resists aneurysm recanalization. NeuroCURE remains a compelling investigational device for the treatment of intracranial aneurysms.

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使用neuroure治疗犬大、宽颈、侧壁动脉瘤:一种新型液体栓塞剂。
背景:未经治疗的颅内动脉瘤可能破裂并导致高发病率和死亡率。虽然有许多被批准的血管内动脉瘤治疗装置,但大多数需要双重抗血小板治疗,生物相容性最低,或容易再通。神经血管控制均匀快速栓塞(neuroure)是一种创新的聚合物凝胶材料,具有长期稳定性,生物相容性和血液相容性,用于治疗大的宽颈动脉瘤。方法:对10只犬行侧壁动脉瘤手术治疗,在单气囊充气周期下,通过0.025微导管注射NeuroCURE。动脉瘤治疗在栓塞后和早产时进行血管造影评估,采用Raymond-Roy闭塞分类和定性血流等级量表。对动脉瘤颈部稳定性和生物相容性进行组织学评估,以血小板/纤维蛋白血栓分级、内皮化百分比和新内膜形成。动脉瘤囊的稳定性通过NeuroCURE囊含量、炎症和新生血管生成量表进行评估。结果:3个月时,切除的动脉瘤颈部表面光滑,新生内膜几乎完全覆盖。到6个月时,所有动物的颈部内皮化率为100%(平均Raymond-Roy闭塞分类为1.2),没有动脉瘤再通或母血管血流受损的情况。生物相容性评估证实缺乏炎症反应、新血管生成和血小板/纤维蛋白血栓形成。结论:随着时间的推移,neuroure材料可以促进宽颈侧壁动脉瘤的进行性闭塞,而不需要双重抗血小板药物。NeuroCURE也促进新生内膜组织填充,而不依赖血栓形成,从而抵抗动脉瘤再通。neuroure仍然是治疗颅内动脉瘤的一种令人信服的研究设备。
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Systematic Review and Meta-Analysis of Endovascular Therapy Effectiveness for Unruptured Saccular Intracranial Aneurysms. Large, Wide-Neck, Side-Wall Aneurysm Treatment in Canines Using NeuroCURE: A Novel Liquid Embolic. Proceedings of the Seventh Annual CLOTS Meeting: CLOTS 7.0, Madrid, Spain Catching Up With Time: Endovascular Treatment Beyond 24 Hours Can Aneurysm Wall Radiomics Help Predict Rupture Risk?
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