Onyx in an experimental aneurysm model: histological and angiographic results

Laboratory investigation

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  • 1 Department of Neuroradiology, University Hospital of Erlangen;
  • 2 Departments of Diagnostic and Interventional Neuroradiology and
  • 3 Neuropathology, University Hospital of the Saarland, Homburg/Saar; and
  • 4 Department of Neuropathology, University Hospital Jena, Germany
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Object

The use of liquid embolic agents for endovascular treatment of cerebral aneurysms is evolving. The authors' aim was to evaluate the use of Onyx HD-500 in an experimental aneurysm model and to obtain histological and angiographic long-term results.

Methods

Ten aneurysms were created using an elastase model in rabbits. The aneurysms were embolized using Onyx in combination with an inflated balloon. One animal died 1 day after embolization. The animals were divided into 2 different groups. The animals in the first group (4 rabbits) were killed at 3 months and those in the second group (5 rabbits) were killed at 6 months after embolization. A venous control angiogram was obtained, and the aneurysms were examined histologically.

Results

In both groups control angiograms demonstrated that all aneurysms were completely occluded. There were no signs of recanalization. Migration of Onyx was seen in 4 animals, leading to the death of 1. Histological examination not only proved the aneurysms to be occluded but also demonstrated a thin layer of endothelium at the neck of the aneurysm. The histological result was identical in both groups.

Conclusions

This is the first study reporting the formation of a neointima over the neck of aneurysms embolized with Onyx in a rabbit model. Although the technique is challenging and migration of the liquid embolic agent cannot always be prevented, Onyx has a great potential to achieve a durable occlusion of aneurysms.

Abbreviations used in this paper: CAMEO = Cerebral Aneurysm Multicenter European Onyx; CCA = common carotid artery; DMSO = dimethyl sulfoxide; IAP = intraaneurysmal pressure.

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Contributor Notes

Address correspondence to: Tobias Struffert, M.D., Department of Neuroradiology, University Clinic of Erlangen, 91054 Erlangen, Germany. email: tobias.struffert@nrad.imed.uni-erlangen.de.
  • 1

    Acar F, , Men S, , Tayfur V, , Yilmaz O, , Erbayraktar S, & Metin Güner E: In vivo intraaneurysmal pressure measurements in experimental lateral wall aneurysms before and after onyx embolization. Surg Neurol 66:252257, 2006

    • Search Google Scholar
    • Export Citation
  • 2

    Carter LP, , Guthkelch AN, , Orozco J, & Temeltas O: Influence of tissue plasminogen activator and heparin on cerebral ischemia in a rabbit model. Stroke 23:883888, 1992

    • Search Google Scholar
    • Export Citation
  • 3

    Cekirge HS, , Saatci I, , Ozturk MH, , Cil B, , Arat A, & Mawad M, : Late angiographic and clinical follow-up results of 100 consecutive aneurysms treated with Onyx reconstruction: largest single-center experience. Neuroradiology 48:113126, 2006

    • Search Google Scholar
    • Export Citation
  • 4

    Cloft HJ, , Altes TA, , Marx WF, , Raible RJ, , Hudson SB, & Helm GA, : Endovascular creation of an in vivo bifurcation aneurysm model in rabbits. Radiology 213:223228, 1999

    • Search Google Scholar
    • Export Citation
  • 5

    Dai D, , Ding YH, , Danielson MA, , Kadirvel R, , Lewis DA, & Cloft HJ, : Histopathologic and immunohistochemical comparison of human, rabbit and swine aneurysms embolized with platinum coils. AJNR Am J Neuroradiol 26:25602568, 2005

    • Search Google Scholar
    • Export Citation
  • 6

    Grunwald IQ, , Romeike B, , Eymann R, , Roch C, , Struffert T, & Reith W: An experimental aneurysm model: a training model for neurointerventionalists. Interventional Neuroradiology 12:1724, 2006

    • Search Google Scholar
    • Export Citation
  • 7

    Grunwald IQ, , Romeike B, , Roth C, , Struffert T, , Eymann R, & Reith W: Anticoagulation regimes and their influence on the occlusion rate of aneurysms: an experimental study in rabbits. Neurosurgery 57:10481055, 2005

    • Search Google Scholar
    • Export Citation
  • 8

    Kerber CW, & Heilmann CB: Flow dynamics for radiologists. Practical considerations in the live human. AJNR Am J Neuroradiol 15:10761086, 1994

    • Search Google Scholar
    • Export Citation
  • 9

    Molyneux A, , Kerr R, , Stratton I, , Sandercock P, , Clarke M, & Shrimpton J, : International Subarachnoid Aneurysm Trial (ISAT) of neurosurgical clipping versus endovascular coiling in 2143 patients with ruptured intracranial aneurysms: a randomised trial. Lancet 360:12671274, 2002

    • Search Google Scholar
    • Export Citation
  • 10

    Molyneux AJ, , Cekirge S, , Saatci I, & Gál G: Cerebral Aneurysm Multicenter European Onyx (CAMEO) trial: results of a prospective observational study in 20 European centers. AJNR Am J Neuroradiol 25:3951, 2004

    • Search Google Scholar
    • Export Citation
  • 11

    Murayama Y, , Viñuela F, , Tateshima S, , Viñuela F Jr, & Akiba Y: Endovascular treatment of experimental aneurysms by use of a combination of liquid embolic agents and protective devices. AJNR Am J Neuroradiol 21:17261735, 2000

    • Search Google Scholar
    • Export Citation
  • 12

    Reul J, , Weis J, , Spetzger U, , Konert T, , Fricke C, & Thron A: Long-term angiographic and histopathologic findings in experimental aneurysms of the carotid bifurcation embolized with platinum and tungsten coils. AJNR Am J Neuroradiol 18:3542, 1997

    • Search Google Scholar
    • Export Citation
  • 13

    Saatci I, , Cekirge S, , Ciceri E, , Mawad M, , Pamuk AG, & Besim A: CT and MR imaging findings and their implications in the follow-up of patients with intracranial aneurysms treated with endosaccular occlusion with onyx. AJNR Am J Neuroradiol 24:567578, 2003

    • Search Google Scholar
    • Export Citation
  • 14

    Weber W, , Kis B, , Siekmann R, & Kuehne D: Endovascular treatment of intracranial arteriovenous malformation with onyx: technical aspects. AJNR Am J Neuroradiol 28:371377, 2007

    • Search Google Scholar
    • Export Citation

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