Particulates from hydrophilic-coated guiding sheaths embolise to the brain

EuroIntervention : Journal of EuroPCR in Collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology
James R L StanleyElazer R Edelman

Abstract

We sought to evaluate the incidence of embolic material in porcine brains following vascular interventions using hydrophilic-coated sheaths. A new self-expanding stent and delivery system (SDS) was deployed through a hydrophilic-coated (Flexor Ansel; Cook Medical, Bloomington, IN, USA) guiding sheath into the iliac and/or carotid arteries of 23 anaesthetised Yucatan mini swine. The animals were euthanised at three, 30, 90 and 180 days and their brains were removed for histological analysis. In an additional single control animal, the guiding sheath was advanced but no SDS was deployed. Advancement of the coated guiding sheath with or without the SDS was associated with frequent foreign material in the arterioles of the brain. The embolic material was amorphous, non-refractile, non-crystalline, non-birefringent and typically lightly basophilic with a slightly stippled appearance on haematoxylin and eosin (H&E) stain. Material was observed at all time points involving 54% of all study animals (i.e., test and control) and in vitro after incubation in 0.9% saline. The hydrophilic coating on a clinically used guiding sheath readily avulses and embolises to the brain during deployment in a porcine model. Further documentation of this...Continue Reading

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Citations

Nov 8, 2016·The American Journal of Surgical Pathology·Jesus A ChavezChristina A Arnold
Mar 8, 2019·Toxicologic Pathology·Molly C FriedemannBrad R Weeks
Jan 22, 2020·Biomedical Instrumentation & Technology·Amitabh Madhukumar ChopraElazer R Edelman
Feb 13, 2016·Journal of Interventional Cardiology·Cindy L GrinesTheodore L Schreiber
Oct 30, 2019·Journal of Vascular Surgery Cases and Innovative Techniques·Gary K YangJoel Gagnon
Sep 22, 2021·Journal of Neurointerventional Surgery·Eimad ShotarFrédéric Clarençon

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