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Acute Thrombus Burden on Coated Flow Diverters Assessed by High Frequency Optical Coherence Tomography.

Abstract：

PURPOSE:The implantation of flow diverters requires administration of dual anti-platelet therapy, posing the potential for complications. The p48MW HPC (phenox, Bochüm, Germany) hydrophilic-coated flow diverting stent is designed to be anti-thrombotic, thus opening the potential for single anti-platelet therapy. We deploy a novel intravascular high-resolution imaging technique, high-frequency optical coherence tomography (HF-OCT), to study in an animal model the acute thrombus formation on coated p48MW devices versus uncoated control devices. METHODS:Three pigs were implanted with 4 flow diverters each, two test hydrophilic-coated devices, and two control uncoated devices (p48MW). Each pig was treated with a different anti-platelet regime: no anti-platelet therapy, aspirin only, aspirin and clopidogrel. Twenty minutes after the flow diverter was implanted, an HF-OCT data set was acquired. Acute clot formed on the flow diverter at each covered side branch was measured from the HF-OCT slices. Factors considered to be important were the device type (pHPC versus bare metal), aspirin, clopidogrel, and vessel location. A linear model was constructed from the significant factors. RESULTS:Both coating (p < 0.001) and aspirin (p = 0.003) were significantly related to reduction in clot burden, leading to an approximate 100-fold and 50-fold reduction in clot, respectively. CONCLUSIONS:This study shows the power of HF-OCT not only in the detection of clot but also the quantification of clot burden. In an animal model, the pHPC-coated p48MW significantly reduced acute thrombus formation over jailed side branches as compared to the bare metal p48MW that was nearly eliminated when combined with aspirin administration.

journal_name

Cardiovasc Intervent Radiol

journal_title

Cardiovascular and interventional radiology

authors

King RM,Langan ET,Ughi GJ,Raskett CM,Puri AS,Henkes H,Gounis MJ

doi

10.1007/s00270-020-02482-w

subject

Has Abstract

pub_date

2020-08-01 00:00:00

pages

1218-1223

issue

eissn

0174-1551

issn

1432-086X

pii

10.1007/s00270-020-02482-w

journal_volume

pub_type

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Acute Thrombus Burden on Coated Flow Diverters Assessed by High Frequency Optical Coherence Tomography.