The effects of stenting and endothelial denudation on aneurysm and branch occlusion in experimental aneurysm models

J Vasc Surg. 2007 Jun;45(6):1228-35. doi: 10.1016/j.jvs.2007.02.060.


Background: Stents are increasingly used in the endovascular treatment of intracranial aneurysms. We studied the effects of stenting and endothelial denudation on aneurysm and branch vessel occlusion.

Methods: Bilateral lingual bifurcation venous pouch aneurysms were created in eight dogs, surgically scraping the aneurysmal endothelial lining on one side. Both arteries were immediately stented using balloon-expandable stents. In four other dogs, a wide-neck carotid bifurcation aneurysm was created, with the vein pouch denuded or not (n=2 each), followed by immediate stenting. Results were compared using angiography and pathology at 10 days (n=2), 10 (n=8), and 20 weeks (n=2). Branch occlusion between initial and final angiograms was recorded. Pathological evaluation of aneurysms was studied, with attention to neointima formation at the aneurysm ostium and around branch vessel origins.

Results: All stented and denuded lingual aneurysms were obliterated compared with two of eight lingual aneurysms that were stented alone (P=.007). None of the carotid bifurcation aneurysms became obliterated (0/4), but denuded aneurysms showed partial thrombosis (2/2). Of 68 total stent-covered branches, 5 (7%) were occluded and 17 (27%) had altered angiographic flow.

Conclusions: Stenting led to suboptimal results in the presence of an intact endothelial layer. Endothelial denudation can promote aneurysm occlusion when combined with stenting.

Publication types

  • Comparative Study

MeSH terms

  • Aneurysm / diagnostic imaging
  • Aneurysm / pathology
  • Aneurysm / surgery*
  • Animals
  • Arteries / surgery
  • Carotid Arteries / surgery
  • Carotid Artery Diseases / diagnostic imaging
  • Carotid Artery Diseases / pathology
  • Carotid Artery Diseases / surgery*
  • Disease Models, Animal
  • Dogs
  • Endothelium, Vascular / pathology*
  • Jugular Veins / surgery
  • Prosthesis Design
  • Radiography
  • Stents*
  • Time Factors
  • Tongue / blood supply*
  • Vascular Surgical Procedures*