Beta Radiation and Inhibition of Recanalization After Coil Embolization of Canine Arteries and Experimental Aneurysms

Author:

Raymond Jean1,Leblanc Philippe1,Morel François1,Salazkin Igor1,Gevry Guylaine1,Roorda Sjoerd1

Affiliation:

1. From the Department of Radiology (J.R.) and Centre de Recherche (J.R., P.L., F.M., I.S., G.G.), Centre Hospitalier de l’Université de Montréal, Hôpital Notre-Dame, and the Physics Department (S.R.), Université de Montréal, Montreal, Quebec, Canada.

Abstract

Background and Purpose— Beta radiation prevents recanalization after coil embolization. We sought to determine the effects of varying coil caliber, length, activity of 32 P per centimeter of coil or per volume, and spatial distribution of coils on recanalization. Methods— We studied the angiographic evolution of 81 canine maxillary, cervical, and vertebral arteries implanted with a variety of nonradioactive (n=29 arteries) or radioactive (n=52) devices. We compared 1- or 2-caliber 0.015 or 0.010 coils ion-implanted or not with 3 different activity levels (0.05 to 0.08, 0.06 to 0.12, 0.18 to 0.32 μCi/cm) of 32 P and totaling 4, 8, and 16 cm in length for the same arterial volume. We also compared inhibition of recanalization by beta radiation delivered by stents, after coil occlusion proximal to or within the stent, with that delivered by coils placed within nonradioactive stents. We finally studied the angiographic evolution of canine lateral wall carotid aneurysms treated with 1 or 2 stents of various activity levels positioned inside the parent artery across the neck. Animals were killed at 4 and 12 weeks for macroscopic photography and pathological examination. Results— All arteries (29 of 29) occluded with nonradioactive devices were recanalized, while 49 of 52 arteries (94%) implanted with 32 P devices were occluded at 4 weeks. All aneurysms treated with stents, radioactive or not, demonstrated residual filling of the sac or of channels leading to the aneurysms at follow-up angiography at 4 weeks. Conclusions— The recanalization process found in the canine arterial occlusion model is minimally affected by coil caliber, number, and length or packing density. Beta radiation reliably inhibits this process, but thrombosis is an essential condition for the efficacy of a radioactive coil strategy.

Publisher

Ovid Technologies (Wolters Kluwer Health)

Subject

Advanced and Specialised Nursing,Cardiology and Cardiovascular Medicine,Clinical Neurology

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