TY - JOUR
T1 - Treatment of Ruptured and Nonruptured Aneurysms Using a Semisolid Iodinated Embolic Agent
AU - Zhang, Zefu
AU - Albadawi, Hassan
AU - Fowl, Richard J.
AU - Altun, Izzet
AU - Salomao, Marcela A.
AU - Jahanyar, Jama
AU - Chong, Brian W.
AU - Mayer, Joseph L.
AU - Oklu, Rahmi
N1 - Funding Information:
The authors acknowledge Anshuman Panda for assistance with CT and MRI imaging; Khan S. Rehman for histology; Naomi M. Gades for veterinary assistance; and JingJie Hu for assistance with the biomaterial preparation and rheology. The authors also gratefully acknowledge funding from the National Institutes of Health (R01CA257558, R01HL140951, R01EB024403, and R01HL137193) and support from the Mayo Clinic.
Publisher Copyright:
© 2022 Wiley-VCH GmbH
PY - 2022/3/10
Y1 - 2022/3/10
N2 - Saccular aneurysms (SAs) are focal outpouchings from the lateral wall of an artery. Depending on their morphology and location, minimally invasive treatment options include coil embolization, flow diverter stents, stent-assisted coiling, and liquid embolics. Many drawbacks are associated with these treatment options including recanalization, delayed healing, rebleeding, malpositioning of the embolic or stent, stent stenosis, and even rupture of the SA. To overcome these drawbacks, a nanoclay-based shear-thinning hydrogel (STH) is developed for the endovascular treatment of SAs. Extensive in vitro testing is performed to optimize STH performance, visualization, injectability, and endothelialization in cell culture. Femoral artery saccular aneurysm models in rats and in pigs are created to test stability, efficacy, immune response, endothelialization, and biocompatibility of STH in both ruptured and unruptured SA. Fluoroscopy and computed tomography imaging consistently confirmed SA occlusion without recanalization, migration, or nontarget embolization; STH is also shown to outperform coil embolization of porcine aneurysms. In pigs with catastrophic bleeding due to SA rupture, STH is able to achieve instant hemostasis rescuing the pigs in long-term survival experiments. STH is a promising semisolid iodinated embolic agent that can change the standard of medical practice and potentially save lives.
AB - Saccular aneurysms (SAs) are focal outpouchings from the lateral wall of an artery. Depending on their morphology and location, minimally invasive treatment options include coil embolization, flow diverter stents, stent-assisted coiling, and liquid embolics. Many drawbacks are associated with these treatment options including recanalization, delayed healing, rebleeding, malpositioning of the embolic or stent, stent stenosis, and even rupture of the SA. To overcome these drawbacks, a nanoclay-based shear-thinning hydrogel (STH) is developed for the endovascular treatment of SAs. Extensive in vitro testing is performed to optimize STH performance, visualization, injectability, and endothelialization in cell culture. Femoral artery saccular aneurysm models in rats and in pigs are created to test stability, efficacy, immune response, endothelialization, and biocompatibility of STH in both ruptured and unruptured SA. Fluoroscopy and computed tomography imaging consistently confirmed SA occlusion without recanalization, migration, or nontarget embolization; STH is also shown to outperform coil embolization of porcine aneurysms. In pigs with catastrophic bleeding due to SA rupture, STH is able to achieve instant hemostasis rescuing the pigs in long-term survival experiments. STH is a promising semisolid iodinated embolic agent that can change the standard of medical practice and potentially save lives.
KW - aneurysm
KW - embolization
KW - endovascular
KW - nanoclay
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U2 - 10.1002/adma.202108266
DO - 10.1002/adma.202108266
M3 - Article
C2 - 34936720
AN - SCOPUS:85123219771
VL - 34
JO - Advanced Materials
JF - Advanced Materials
SN - 0935-9648
IS - 10
M1 - 2108266
ER -