Work

O-058 Evaluation of a novel embolic agent impass in swine model of middle meningeal artery embolization

Year: 2024

Type: conference-paper

Abstract: Background Middle meningeal artery (MMA) embolization has emerged as a promising stand-alone or adjunct treatment for patients with chronic subdural hematomas (cSDH). Improved penetration of the MMA is believed to improve the efficacy of the embolization procedure and its long-term clinical success. The goal of this feasibility study is to evaluate the performance of a novel liquid embolic (IMPASS, Fluidx Medical Technology) compared with a control (Onyx 18, Medtronic) in a swine MMA embolization model. Materials and Methods IMPASS is a water-based liquid embolic material which follows vascular flow and is designed for deep distal penetration. It is DMSO free and requires minimal preparation. Preclinical studies have demonstrated long-term occlusion without recanalization, and desirable handling characteristics. The test article could be well-suited for non-shunting neurovascular applications such as MMA embolization and meningiomas. Bilateral MMA branches of the external carotid artery were targeted for microcatheter access. The control embolic was delivered to the left MMA and the test embolic was delivered to the right MMA. The control embolic and test embolic were delivered through Apollo (Medtronic) and Headway Duo (Terumo MicroVention) microcatheters, respectively. Arteriography was used to determine success of embolization immediately following each procedure. After six days, the swine was sacrificed, and a histological evaluation was conducted on both sides of the brain. On each side, five sections of tissue were taken for evaluation with each section including meninges and adjacent brain (figure 1A). Results The middle meningeal arteries on both sides were successfully accessed and both the test and control embolic devices were able to be delivered. Arteriography confirmed full occlusion of the MMA by both test and control embolics. The control article was found to reach vessels with an approximate diameter of 60 microns and the test article was found to reach arterioles down to approximately 8 microns in diameter. Observed inflammation was insignificant, with minimal inflammation in the region of the control embolic and localized mild inflammation in the arachnoid space/pial meninges immediately adjacent to the affected dural arteria for the test embolic (figure 1B). Conclusion Our early feasibility data using IMPASS demonstrated deep distal penetration indicating that it may be well suited for MMA embolization in patients with cSDH and other non-shunting neurovascular applications. Future studies are planned. Disclosures M. Mokin: 1; C; NIH. 2; C; Balt, Cerenovus, Medtronic, Rapid Pulse. 4; C; Bendit Technologies, Borvo medical, BrainQ, Endostream, Radical Catheter Technologies, Serenity medical, Synchron, Sim&Cure, QAS.AI, Quantanosis.AI. A. Siddiqui: 1; C; NIH. 2; C; Amnis Therapeutics, Apellis Pharmaceuticals, Inc., Boston Scientific, Canon Medical Systems USA, Inc., Cardinal Health 200, LLC, Cerebrotech Medical Systems, Inc., Cerenovus, Cordis, Corindus, Inc., E. 4; C; Adona Medical, Inc., Bend IT Technologies, Ltd., BlinkTBI, Inc, Borvo Medical, Inc., Cerebrotech Medical Systems, Inc., Code Zero Medical, Inc., Cognition Medical, Collavidence, Inc., CVAID Ltd., E8,. K. Meess-Tuttle: None. M. Spengler: None. Y. Akkad: None. D. Pionessa: None. C. Koenigsknecht: None. L. Gutierrez: 4; C; QAS.AI. M. Bainsmith: None. D. Smith: None.

Source: Society of NeuroInterventional Surgery Annual Meeting (SNIS)

DOI: 10.1136/jnis-2024-snis.58