Are you M Haklin?

Claim your profile

Publications (5)15.84 Total impact

  • [Show abstract] [Hide abstract]
    ABSTRACT: Carotid fusiform aneurysms are most commonly treated with occlusion of the parent vessel. The purpose of our study was to assess the effectiveness of self-expanding, cobalt-alloy stents in the ablation of experimental fusiform aneurysms with preservation of the parent vessel in a carotid artery model. Porous metallic stents were placed endovascularly along the lengths of experimentally created fusiform aneurysms in the carotid arteries of dogs; aneurysms were also created in the animals' opposite carotid arteries to serve as controls. Before stent placement, angiography of the carotid arteries showed large fusiform aneurysms along the lengths of the common carotid arteries and complex patterns of flow. Immediately after stent placement there was disruption of the usual flow patterns within the lumens of the fusiform aneurysms. The lumen between the wall of the aneurysm and stented carotid showed stasis of contrast material and blood. Near-complete ablation of all aneurysms was observed 8 weeks after stent placement. The stented carotid arteries remained widely patent; control aneurysms and carotid arteries were patent and unchanged. Histopathologic analysis revealed fibrotic reactive scar tissue filling the space between the stent wires and outer wall of the fusiform aneurysm. Changing blood flow dynamics within an aneurysm can promote thrombus formation. The stent promotes stasis and thrombus within the residual lumen between the stent wall and the outer wall of the aneurysm because its woven wire mesh interferes with usual blood flow patterns, which then promotes formation of thrombus and fibrosis within the residual aneurysmal lumen.
    American Journal of Neuroradiology 05/2000; 21(4):739-45. · 3.17 Impact Factor
  • Source
    G Geremia, M Haklin
    [Show abstract] [Hide abstract]
    ABSTRACT: Our experimental study in dogs suggests that laser-activated detachable coil devices show promise in the embolization of carotid aneurysms, allowing the interventionalist greater control than possible with nonretractable coil systems and permitting detachment of the coil from the wire in seconds.
    American Journal of Neuroradiology 04/1998; 19(3):566-9. · 3.17 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: To determine the efficacy of silicone-covered metallic stents in the treatment of experimentally created carotid-jugular fistulas. Carotid-jugular fistulas were surgically constructed in six mongrel dogs. Silicone-coated, self-expanding metallic stents were placed across the fistula holes within the carotid artery, and carotid angiography was performed before, immediately after, and 4 and 8 weeks after stent placement. Fistula specimens were resected 2 months after stent placement and analyzed by means of gross and light microscopy. Angiography revealed complete closure of all fistulas immediately after stent deployment. The fistulas remained closed and all carotid arteries remained patent. Marked stenosis within the carotid lumen was seen along the proximal and distal ends of the stents. Gross and micropathologic specimens of the carotid-jugular fistulas revealed fibrous connective tissue and collagen across the fistula holes. Proliferative fibrous connective tissue, collagen, and fibromyoblasts were located at either end of the stents. The wires of the stents indented the intraluminal surface of the carotid arteries. Silicone-covered stents were effective in closing all experimentally created carotid-jugular fistulas. With further refinements and variations in technique, covered stents may prove a viable alternative to current endovascular devices.
    American Journal of Neuroradiology 03/1997; 18(2):271-7. · 3.17 Impact Factor
  • G Geremia, M Haklin, L Brennecke
    [Show abstract] [Hide abstract]
    ABSTRACT: To assess the effectiveness of self-expanding, cobalt-alloy stents in the treatment of aneurysms in a canine model and to observe the pattern of blood flow and formation of fibrotic scar tissue. Porous metallic stents were endovascularly placed across the necks of experimentally created side aneurysms in the carotid arteries of three dogs; aneurysms were also created in the opposite carotid arteries in these animals to serve as controls. Before stent placement, angiography of the carotid arteries demonstrated whirl-like, vortex flow of blood within the lumens of the aneurysms. Inflow was seen along the distal aneurysm wall; outflow was demonstrated along the proximal wall; slower vortex flow was present in the central lumen. Immediately after stent placement there was disruption of the usual vortex flow with stasis of contrast media and blood within the lumen. Inflow and outflow patterns were no longer seen. Complete ablation of these aneurysms was evident at follow-up angiographic studies--1 week, 1 month, and 2 months after stent placement. The stented carotid arteries remained widely patent; control aneurysms and carotid arteries were patent and unchanged. Histopathologic analysis revealed fibrotic reactive scar tissue completely filling the stented aneurysm pouches. Treatment of selected intracranial aneurysms via an endovascular approach has merit and could supplant more invasive, risky, and costly surgical procedures in some cases.
    American Journal of Neuroradiology 09/1994; 15(7):1223-31. · 3.17 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: To determine the efficacy of porous metallic stents in the treatment of experimentally created carotid-jugular fistulas. Carotid-jugular fistulas were constructed surgically in five mongrel dogs. Porous metallic stents were placed endovascularly across the fistula holes within the carotid artery; carotid angiography was performed before, immediately after, and 1 and 2 months after stent placement. The fistula specimens were resected 2 months after stent placement; gross and light microscopic analyses were performed. Angiography revealed complete closure of three of the five fistulas 1 month after stent placement; two of the five fistulas remained patent but demonstrated diminished flow rate. All carotid arteries were widely patent throughout the study. Gross pathology of the carotid-jugular specimens revealed fibrous connective tissue and collagen within the fistula hole. A thin layer of endothelium covered the stent wires and the fibrous connective tissue overlying the fistula hole. The stents were effective in closing three of the five fistulas and reducing flow through the fistulas in the remaining animals. With further refinements and variations in technique, porous metallic stents may prove a viable alternative to current endovascular devices for treatment of certain arteriovenous fistulas.
    American Journal of Neuroradiology 16(10):1965-73. · 3.17 Impact Factor