The long-term objective of this project is to treat wide-necked intracranial aneurysms via the endovascular approach rather than by the classic surgical intervention. Small-necked aneurysms are currently treated, either surgically or endovascularly, with acceptable morbi/mortality rates. Currently, most wide-necked intracranial large and giant aneurysms carry a high surgical risk or remain inoperable. The immediate aim of this study is to create experimental wide-necked aneurysms onto the common carotid artery of swine. Three hypotheses will be tested: 1) The aneurysm will be partially occluded with platinum detachable coils and electrothrombosis (past proposal) via the endovascular approach. Then an external radiofrequency generator (solenoid), producing an electromagnetic field, will heat the coils by promoting an induced current within the coils. The heat generated will enhance thrombosis so that the entire aneurysm will be occluded. 2) A soft endovascular guidewire is positioned against the aneurysm neck. An external radiofrequency generator, tuned and connected to the proximal end of the wire, will produce an induced convergence current at the wire tip. The heat generated will cause shrinkage of the aneurysm neck by promoting collagen retraction. The wide-necked aneurysm is therefore transformed into a small-necked one, amenable to treatment with platinum detachable coils (past proposal). 3) A plastic expandable endovascular prosthesis will be positioned and detached in the parent vessel across the aneurysm neck. Bridging of the latter with the prosthesis will exclude the aneurysm from the circulation, eliminating the risk of aneurysm rupture and preserving the parent artery. Many lives could be saved with this endovascular technique of occlusion of wide-necked intracranial aneurysms.
