Revolutionizing brain aneurysm treatments

Brain aneurysms often go unnoticed by those afflicted by them. Unless an aneurysm ruptures, patients can go about their day, completely unaware of the deadly vascular defect.

Functioning blood vasculature allows blood to flow like rivers, says Chris Bettinger, an associate professor of materials science and engineering and biomedical engineering. An aneurysm occurs when the weakened vessels lead to a bulge in vasculature, causing blood to pool in the bulge, much like stagnant bogs might form after part of a riverbank collapses.

Ruptured aneurysms can occur at any age, and the mortality rate is almost 60 percent without treatment. Current aneurysm treatments involve endovascular therapy, which is administered through a catheter. Surgeons insert a platinum coil through the catheter and directly into the defect, causing a blood clot and ultimately sealing off the vasculature defect, rebuilding the riverbank. Unfortunately, treatment fails 30 percent of the time because the body breaks down and absorbs the tissue clot, and the aneurysm forms again.

Current treatments are temporary solutions that the body eventually processes.

Chris Bettinger, Associate Professor, Materials Science & Engineering and Biomedical Engineering

“Current treatments are temporary solutions that the body eventually processes,” says Bettinger. “When the clot fails, weeks later, months later, or years later, a patient has to undergo the same procedure again.”

Surgeons have to perform the same procedure, and patients face
 a 30 percent failure rate yet again. This model isn’t sustainable, so Bettinger teamed up with Ancure, LLC, a Pittsburgh-based company that specializes in medical device coatings, as well as Michael Horowitz, a neurosurgeon at the Pennsylvania Brain and Spine Institute.

The team aims to make aneurysm treatments more permanent. Through a grant from the Pennsylvania Infrastructure Technology Alliance, the team has been testing GeniCoat, a genipin-based, controlled release material. Genipin is a chemical compound derived from gardenia fruit extract that serves as an extremely successful cross-linker for proteins. This creates a much more stable clot.

Once a coil is administered, the controlled release of genipin would begin. The clot would be reinforced and strengthened by cross-linked proteins, cutting the failure rate in half, to just 15 percent.

It’s our hope that with this particular treatment, patients can receive just one surgery and be finished.

Michael Horowitz, Neurosurgeon, Pennsylvania Brain and Spine Institute

Traditional platinum coils result in the eventual destabilization of a fixed blood clot. Genipin-coated platinum coils result in the stabilization of a treated aneurysm.

“This genipin coil coating has the potential to reduce incidents of aneurysm recurrence,” says Horowitz. “It’s our hope that with this particular treatment, patients can receive just one surgery and be finished.”

The initial PITA-funded in vitro component of this study has been successful. Now the team has partnered with Mayo Clinic for the in vivo component of the study.