acetylcellulose and Aneurysm

To re-evaluate the safety, effect, and pathological reactions of cellulose acetate polymer (CAP).. 30 right carotid arteries of rats were embolized and got two embolized vessels for histological study in each of the seven stages within four months. Fifteen canine aneurysmal models were created by transplantation of venous pouches. Twelve of them were occluded with CAP. Digital Subtraction Angiography (DSA) follow-ups of occluded aneurysmal models were carried out 1, 2 and 8 weeks after occlusion. One animal was sacrificed randomly at each stage for pathological study.. Only five of the 12 aneurysmal models were completely or partially occluded within the patency of parent arteries within two months of observation after embolization with CAP. Stenosis of one branch of aneurysmal parent artery was occurred. The residual cavity of one partially occluded model artery was enlarged. Two models ruptured on four and five days after embolization. Three embolized models and their parent arteries were all occluded.. acute pathological reaction occurred within vessels embolized with CAP. Endothelial cell and basal membrane were damaged and vanished. Elastic lamina was exposed to arterial lumen and attached by thrombus layer. Fibrous cells and smooth muscle cells showed obvious degeneration. CAP and thrombus were gradually organized in two months after thrombosis. The orifices of aneurysmal models were covered with newly developed fibrous tissue and endothelial cells in two months after thrombosis.. We think that acute chemical erosive effect of CAP was evident. A strong effect could lead to rupture of some of the CAP thrombosed aneurysmal models. Besides, stenosis or occlusion of the parent arteries could be induced in some cases after embolization with CAP. For the above shortcomings and limitations, it should be improved carefully before it is applied in clinic.

Topics: Aneurysm; Animals; Carotid Arteries; Cellulose; Dogs; Drug Evaluation, Preclinical; Embolization, Therapeutic; Rats

Cellulose acetate polymer (CAP) solution is a new liquid embolic material, and it has been used clinically for the thrombosis of cerebral aneurysms. The purpose of the study was to test a method of aneurysm treatment. In an experimental model, retrievable interlocking detachable coils (IDCs) were used to create an intraaneurysmal frame or prop and then CAP was injected into 20 experimentally induced canine cervical aneurysms. Intraaneurysmal thrombosis was induced 1 week after aneurysm creation. Complete thrombosis was attempted in 12 aneurysms, and partial thrombosis was attempted in 4. Four other aneurysms served as controls. Follow-up angiography was performed for up to 8 weeks, and with the exception of 4 aneurysms, which were kept for a 2-year long-term follow-up study, the aneurysms were then harvested for histological examination. Thrombosis was successfully achieved in all cases except for 2 enlarged aneurysms that were initially partially thrombosed. No thromboembolism to distal vessels was observed. No compaction or shift of the CAP-IDC complex occurred even after 2 years. Histologically, CAP and IDCs conformed to the massive thrombotic complex without any fragmentation. By creating a frame or prop with retrievable microcoils, we were able to inject the CAP implies a comparison safely and precisely than has been previously reported. Our findings suggest that this method will be useful for the treatment of cerebral aneurysms.

Topics: Aneurysm; Angiography; Animals; Carotid Artery Diseases; Cellulose; Dogs; Embolization, Therapeutic; Neck; Platinum; Polymers

To investigate the usefulness of a cellulose acetate polymer (CAP) solution for partial thrombosis of aneurysms.. We created 14 canine cervical carotid bifurcation aneurysms, 11 of which were subsequently thrombosed partially with CAP solution. We then conducted angiographic and histological investigations.. Nine aneurysms were thrombosed 50 to 70% by volume, although a significant crescent crevice between the aneurysmal sac and the CAP mass was left in four of the aneurysms. In the remaining two aneurysms in which a crescent crevice had been seen in the initial stage of CAP injection, 80% and more than 95% thrombosis were needed to occlude the crevice, respectively. Follow-up angiograms of the seven aneurysms with no crescent crevice revealed no shifts of position of the CAP mass toward the bottom of the aneurysm sac, but slight ballooning of the remnants was observed in two of them. The angiograms of the other four aneurysms with significant crescent crevices demonstrated rupture with a massive hematoma in one and shifts of the CAP mass with marked enlargement of remnants in three. Histologically, the seven aneurysms with no enlarged remnants had newly developed membranes consisting of endothelium, infiltrated spindle-shaped cells, collagen, and elastic fibers. In contrast, in the three markedly enlarged aneurysms, there were only recent clots between the CAP mass and the aneurysm lumen and no development of endothelium.. Partial thrombosis with CAP solution is useful to keep aneurysms in a stable configuration, unless a crescent crevice has been left.

Topics: Aneurysm; Animals; Carotid Artery, Common; Cellulose; Dogs; Embolization, Therapeutic; Endothelium, Vascular; Evaluation Studies as Topic; Polymers; Prostheses and Implants; Radiography

Liquid polymers have previously been used to treat experimental and human aneurysms. However, the delivery of a liquid embolic material into the cerebral circulation involves a high risk of irreversible vessel occlusion and stroke. To evaluate methods for the safe and effective treatment of experimental aneurysms with liquid polymer injection, we tested four different techniques to deliver cellulose acetate polymer (CAP) or N-hexyl-cyanoacrylate into canine side-wall carotid artery aneurysms. The animals were observed for 1 to 10 weeks after treatment. Two aneurysms were treated without protection of the distal circulation, one with CAP and another with N-hexyl-cyanoacrylate. In four cases, an angioplasty balloon was inflated within the parent artery during endosaccular injection of CAP. In two of these cases, the balloon was placed adjacent to the aneurysm orifice, resulting in simultaneous occlusion of both the aneurysm and the parent artery, and in the other two cases, the balloon was positioned proximal to the aneurysm, resulting in temporary flow arrest. Three aneurysms were treated with either CAP or N-hexyl-cyanoacrylate after implantation of a balloon-expandable tantalum stent within the parent artery across the aneurysm orifice. Complete angiographic obliteration was achieved in all but one case. One aneurysm ruptured. Another partially occluded aneurysm reopened 10 weeks after treatment. In all cases treated without stents, distal migration of the polymer resulted in either stenosis or occlusion of the parent arteries. The combination of stent implantation and polymer injection resulted in permanent aneurysm occlusion without detectable polymer migration. An intravascular stent deployed within the parent artery across the aneurysm orifice acted as a safety net during endosaccular polymer injection by allowing blood to flow from the aneurysm cavity while preventing distal migration of liquid polymer.

Topics: Aneurysm; Angiography, Digital Subtraction; Animals; Carotid Artery Diseases; Catheterization; Cellulose; Cyanoacrylates; Dogs; Injections; Polymers; Stents

The authors have developed a liquid material for thrombosing aneurysms. This material is a mixture of cellulose acetate polymer and bismuth trioxide dissolved in dimethyl sulfoxide. On contact with blood, the dimethyl sulfoxide diffuses and cellulose acetate polymer forms, which balloons when slowly injected into the blood. The polymer solidifies from surface to core in 5 minutes. Cellulose acetate polymer was injected directly into experimental aneurysms created in 10 dogs; it rapidly hardened in the shape of the aneurysms, completely obliterating them but preserving the parent vessels in all cases. No distal migration of the polymer was seen. The good results of this experimental trial led to a clinical study using a cellulose acetate polymer, as described in Part II.

Topics: Aneurysm; Animals; Carotid Artery Diseases; Cellulose; Dogs; Embolization, Therapeutic; Injections, Intra-Arterial; Polymers; Radiography; Renal Artery