Human placenta as an ex vivo vascular model for neurointerventional research

Kwok, John Ching Kwong
Huang, Wei
Leung, Wing-Cheong
Chan, Siu-Ki
Chan, Kwong-Yau
Leung, Kar-Ming
Chu, Alberto Chi Ho
Lam, Alexander Kar Ngai

¹Department of Neurosurgery, Kwong Wah Hospital, Kowloon, Hong Kong
²Division of Biomedical Engineering, Hong Kong University of Science and Technology, Kowloon, Hong Kong
³Department of Mechanical Engineering, Hong Kong University of Science and Technology, Kowloon, Hong Kong
⁴Department of Obstetrics and Gynecology, Kwong Wah Hospital, Kowloon, Hong Kong
⁵Department of Pathology, Kwong Wah Hospital, Hong Kong, Kowloon, Hong Kong

Dr J C K Kwok, Department of Neurosurgery, Kwong Wah Hospital, 25 Waterloo Road, Kowloon, Kowloon, Hong Kong; [email protected]

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Received May 6, 2013

Accepted July 5, 2013

Journal of NeuroInterventional Surgery 6(5):p 394-399, June 2014. | DOI: 10.1136/neurintsurg-2013-010813

Background

Human placenta is a convenient resource for biomedical research, and has not yet been used for neurointerventional surgery research.

Objective

Our objective was to explore the feasibility of using human placenta to test various endovascular interventions and for training.

Design

18 placentas soon after delivery were prepared for six pilot studies. (1) Study on anatomical similarity to human cerebral vessel. (2) Simulation of stent assisted coiling and flow diversion on an aneurysm model. (3) Simulation of intra-arterial thrombolysis. (4) Simulation of embolization of arteriovenous malformation with glues. (5) Simulation of mechanical thrombolysis and comparison of different devices. (6) Vascular model for training of neurointerventionalists.

Results

When the chorionic plate vessels were compared with the cerebral cortical vessels, similarities were found in vascular branch patterns, histological cross sections, and angiographic appearances. Due to the semitransparency of its vessel wall, performance of flow diverter and stent assisted coiling of an aneurysm could be visualized under direct microscopic observation. Similarly, timing of clot lysis and glue polymerization could be estimated. Endothelial change after thrombectomy could be assessed by histological methods. From these pilot studies, the placenta model could be adopted to simulate various clinical situations. It is also ideal for interventional radiology training.

Conclusions

It is feasible to adopt the human placenta as an ex vivo vascular model in neurointerventional surgery research due to the fact that its vessels resemble the brain vasculature.