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Testing flow diversion in animal models: a systematic review

  • Interventional Neuroradiology
  • Published:
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Abstract

Introduction

Flow diversion (FD) is increasingly used to treat intracranial aneurysms. We sought to systematically review published studies to assess the quality of reporting and summarize the results of FD in various animal models.

Methods

Databases were searched to retrieve all animal studies on FD from 2000 to 2015. Extracted data included species and aneurysm models, aneurysm and neck dimensions, type of flow diverter, occlusion rates, and complications. Articles were evaluated using a checklist derived from the Animal Research: Reporting of In Vivo Experiments (ARRIVE) guidelines.

Results

Forty-two articles reporting the results of FD in nine different aneurysm models were included. The rabbit elastase-induced aneurysm model was the most commonly used, with 3-month occlusion rates of 73.5 %, (95 %CI [61.9–82.6 %]). FD of surgical sidewall aneurysms, constructed in rabbits or canines, resulted in high occlusion rates (100 % [65.5–100 %]). FD resulted in modest occlusion rates (15.4 % [8.9–25.1 %]) when tested in six complex canine aneurysm models designed to reproduce more difficult clinical contexts (large necks, bifurcation, or fusiform aneurysms). Adverse events, including branch occlusion, were rarely reported. There were no hemorrhagic complications. Articles complied with 20.8 ± 3.9 of 41 ARRIVE items; only a small number used randomization (3/42 articles [7.1 %]) or a control group (13/42 articles [30.9 %]).

Conclusion

Preclinical studies on FD have shown various results. Occlusion of elastase-induced aneurysms was common after FD. The model is not challenging but standardized in many laboratories. Failures of FD can be reproduced in less standardized but more challenging surgical canine constructions. The quality of reporting could be improved.

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Acknowledgments

RF receives a research scholarship from the Fondation pour la Recherche Médicale (FRM), Paris, FRANCE (grant number DEA20140630151). Tim Darsaut received a research grant from the Heart and Stroke Foundation of Alberta (grant # GIA-0200296).

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Authors and Affiliations

  1. Centre Hospitalier de l’Université de Montréal (CHUM), Research Centre, Interventional Neuroradiology Laboratory, Montreal, Quebec, Canada

    Robert Fahed, Jean Raymond, Célina Ducroux, Igor Salazkin & Guylaine Gevry

  2. Centre Hospitalier de l’Université de Montréal (CHUM), Notre-Dame Hospital, Department of Radiology, 1560 Sherbrooke East, Pavilion Simard, Suite Z12909, Montreal, Quebec, Canada, H2L 4M1

    Jean Raymond & Jean-Christophe Gentric

  3. Groupe d’étude de la Thrombose en Bretagne Occidentale (GETBO, EA 3878), Brest, France

    Jean-Christophe Gentric

  4. Centre Hospitalier de l’Université de Montréal (CHUM), Direction de l’Enseignement et de l’Académie CHUM|Bibliothèque, Montreal, Quebec, Canada

    Daniela Ziegler

  5. Department of Surgery, Division of Neurosurgery, University of Alberta Hospital, Mackenzie Health Sciences Centre, Edmonton, Alberta, Canada

    Tim E. Darsaut

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  1. Robert Fahed
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  2. Jean Raymond
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Correspondence to Jean Raymond.

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Fahed, R., Raymond, J., Ducroux, C. et al. Testing flow diversion in animal models: a systematic review. Neuroradiology 58, 375–382 (2016). https://doi.org/10.1007/s00234-015-1635-0

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