{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T08:32:07Z","timestamp":1790065927575,"version":"4.0.1"},"reference-count":28,"publisher":"BMJ","issue":"4","funder":[{"name":"Medtronic Neurovascular"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["J NeuroIntervent Surg"],"accepted":{"date-parts":[[2017,5,26]]},"published-print":{"date-parts":[[2018,4]]},"abstract":"<jats:sec><jats:title>Purpose<\/jats:title><jats:p>Thromboembolic complications remain a limitation of flow diverting stents. We hypothesize that phosphorilcholine surface modified flow diverters (Pipeline Flex with Shield Technology, sPED) would have less acute thrombus formation on the device surface compared with the classic Pipeline Embolization device (cPED).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Elastase-induced aneurysms were created in 40 rabbits and randomly assigned to receive cPED or sPED devices with and without dual antiplatelet therapy (DAPT) (four groups, n=10\/group). Angioplasty was performed to enhance apposition and create intimal injury for a pro-thrombotic environment. Both before and after angioplasty, the flow diverter was imaged with intravascular optical coherence tomography. The outcome measure was the number of predefined segments along the implant relative to the location of the aneurysm with a minimum of 0 (no clot formation) and maximum of 3 (all segments with thrombus). Clot formation over the device at ostia of branch arteries was assessed as either present or absent.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Following angioplasty, the number of flow diverter segments with clots was significantly associated with the flow diverter (p&lt;0.0001), but not with DAPT (p=0.3872) or aneurysm neck size (p=0.8555). The incidence rate for clots with cPED was 1.72 times more than with sPED. The clots on the flow diverter at the location corresponding to side branch ostia was significantly lower with sPED than with cPED (OR 0.180; 95%\u2009CI 0.044 to 0.734; p=0.0168), but was not associated with DAPT (p=0.3198).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In the rabbit model, phosphorilcholine surface modified flow diverters are associated with less thrombus formation on the surface of the device.<\/jats:p><\/jats:sec>","DOI":"10.1136\/neurintsurg-2017-013175","type":"journal-article","created":{"date-parts":[[2017,7,9]],"date-time":"2017-07-09T00:20:19Z","timestamp":1499559619000},"page":"406-411","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":70,"title":["Acute thrombus formation on phosphorilcholine surface modified flow diverters"],"prefix":"10.1136","volume":"10","author":[{"given":"Miklos","family":"Marosfoi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frederic","family":"Clarencon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erin T","family":"Langan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert M","family":"King","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olivia W","family":"Brooks","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takamisu","family":"Tamura","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John M","family":"Wainwright","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew J","family":"Gounis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Srinivasan","family":"Vedantham","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ajit S","family":"Puri","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2017,7,8]]},"reference":[{"key":"2024052303484707000_10.4.406.1","doi-asserted-by":"crossref","unstructured":"Kallmes DF , Brinjikji W , Cekirge S , et al . Safety and efficacy of the pipeline embolization device for treatment of intracranial aneurysms: a pooled analysis of 3 large studies. J Neurosurg 2016:1\u20136.doi:10.3171\/2016.8.JNS16467","DOI":"10.3171\/2016.8.JNS16467"},{"key":"2024052303484707000_10.4.406.2","doi-asserted-by":"publisher","DOI":"10.3174\/ajnr.A4078"},{"key":"2024052303484707000_10.4.406.3","doi-asserted-by":"crossref","first-page":"40","DOI":"10.1093\/neuros\/nyw014","article-title":"Long-Term clinical and angiographic outcomes following\u00a0pipeline embolization device treatment of complex internal carotid artery aneurysms: five-year results of the pipeline for uncoilable or failed aneurysms trial","volume":"80","author":"Becske","year":"2017","journal-title":"Neurosurgery"},{"key":"2024052303484707000_10.4.406.4","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.115.010522"},{"key":"2024052303484707000_10.4.406.5","doi-asserted-by":"crossref","first-page":"188","DOI":"10.1016\/j.ahj.2005.05.013","article-title":"Latin American randomized trial of balloon angioplasty versus coronary stenting in diabetic patients with small vessel reference size (Latin American small vessel [LASMAL II] Trial): immediate and long-term results","volume":"150","author":"Rodriguez","year":"2005","journal-title":"Am Heart J"},{"key":"2024052303484707000_10.4.406.6","doi-asserted-by":"crossref","unstructured":"Hagen MW , Girdhar G , Wainwright J , et al . Thrombogenicity of flow diverters in an ex vivo shunt model: effect of phosphorylcholine surface modification. J Neurointerv Surg 2016:Published Online First:\u00a031 October 2016.\u00a0doi:\u00a010.1136\/neurintsurg-2016-012612.","DOI":"10.1136\/neurintsurg-2016-012612"},{"key":"2024052303484707000_10.4.406.7","doi-asserted-by":"publisher","DOI":"10.2214\/ajr.174.2.1740349"},{"key":"2024052303484707000_10.4.406.8","first-page":"1964","article-title":"Contrast injection via the central artery of the left ear in rabbits: a new technique to simplify follow-up studies","volume":"26","author":"Miskolczi","year":"2005","journal-title":"Am J Neuroradiol"},{"key":"2024052303484707000_10.4.406.9","doi-asserted-by":"publisher","DOI":"10.3174\/ajnr.A3075"},{"key":"2024052303484707000_10.4.406.10","doi-asserted-by":"crossref","unstructured":"Rouchaud A , Ramana C , Brinjikji W , et al . Wall Apposition is a key factor for Aneurysm occlusion after flow diversion: a histologic evaluation in 41 rabbits. Am J Neuroradiol 2016:2087\u201391.doi:10.3174\/ajnr.A4848","DOI":"10.3174\/ajnr.A4848"},{"key":"2024052303484707000_10.4.406.11","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2006.01.031"},{"key":"2024052303484707000_10.4.406.12","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2009.06.019"},{"key":"2024052303484707000_10.4.406.13","doi-asserted-by":"publisher","DOI":"10.1136\/neurintsurg-2011-010102"},{"key":"2024052303484707000_10.4.406.14","doi-asserted-by":"publisher","DOI":"10.1136\/neurintsurg-2015-011843"},{"key":"2024052303484707000_10.4.406.15","doi-asserted-by":"publisher","DOI":"10.1136\/neurintsurg-2015-011771"},{"key":"2024052303484707000_10.4.406.16","doi-asserted-by":"publisher","DOI":"10.15274\/INR-2014-10070"},{"key":"2024052303484707000_10.4.406.17","doi-asserted-by":"crossref","first-page":"129","DOI":"10.1177\/1591019916681981","article-title":"Use of self-expanding stents for better intracranial flow diverter wall apposition","volume":"23","author":"K\u00fchn","year":"2017","journal-title":"Interv Neuroradiol"},{"key":"2024052303484707000_10.4.406.18","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1227\/NEU.0000000000000978","article-title":"P2Y12 reaction units: effect on hemorrhagic and thromboembolic complications in patients with cerebral aneurysms treated with the pipeline embolization device","volume":"78","author":"Daou","year":"2016","journal-title":"Neurosurgery"},{"key":"2024052303484707000_10.4.406.19","doi-asserted-by":"crossref","first-page":"iii3","DOI":"10.1136\/neurintsurg-2012-010582","article-title":"Pre-procedure P2Y12 reaction units value predicts perioperative thromboembolic and hemorrhagic complications in patients with cerebral aneurysms treated with the pipeline embolization device","volume":"5 Suppl 3","author":"Delgado Almandoz","year":"2013","journal-title":"J Neurointerv Surg"},{"key":"2024052303484707000_10.4.406.20","doi-asserted-by":"publisher","DOI":"10.3174\/ajnr.A3621"},{"key":"2024052303484707000_10.4.406.21","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1209979"},{"key":"2024052303484707000_10.4.406.22","doi-asserted-by":"publisher","DOI":"10.1136\/neurintsurg-2015-012091"},{"key":"2024052303484707000_10.4.406.23","doi-asserted-by":"publisher","DOI":"10.3174\/ajnr.A4807"},{"key":"2024052303484707000_10.4.406.24","doi-asserted-by":"crossref","first-page":"512","DOI":"10.1055\/s-0037-1615238","article-title":"The antiaggregating and antithrombotic activity of clopidogrel is potentiated by aspirin in several experimental models in the rabbit","volume":"80","author":"Herbert","year":"1998","journal-title":"Thromb Haemost"},{"key":"2024052303484707000_10.4.406.25","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.113.002565"},{"key":"2024052303484707000_10.4.406.26","doi-asserted-by":"publisher","DOI":"10.1160\/TH14-04-0388"},{"key":"2024052303484707000_10.4.406.27","doi-asserted-by":"publisher","DOI":"10.1124\/jpet.116.236034"},{"key":"2024052303484707000_10.4.406.28","doi-asserted-by":"crossref","first-page":"1855","DOI":"10.1111\/jth.13377","article-title":"A rabbit model of cerebral microembolic signals for translational research: preclinical validation for aspirin and clopidogrel","volume":"14","author":"Zhou","year":"2016","journal-title":"J Thromb Haemost"}],"container-title":["Journal of NeuroInterventional Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/neurintsurg-2017-013175","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,23]],"date-time":"2024-05-23T11:45:45Z","timestamp":1716464745000},"score":1,"resource":{"primary":{"URL":"https:\/\/jnis.bmj.com\/lookup\/doi\/10.1136\/neurintsurg-2017-013175"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,7,8]]},"references-count":28,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2018,3,19]]},"published-print":{"date-parts":[[2018,4]]}},"alternative-id":["10.1136\/neurintsurg-2017-013175"],"URL":"https:\/\/doi.org\/10.1136\/neurintsurg-2017-013175","relation":{},"ISSN":["1759-8478","1759-8486"],"issn-type":[{"value":"1759-8478","type":"print"},{"value":"1759-8486","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,7,8]]}}}