Dynamic laser-based photomodulation of endovascular hydrogel embolization for the treatment of various cerebrovascular disorders

Introduction: Endovascular embolization is becoming an increasingly utilized method of treating a variety of neurovascular disorders, including aneurysms, arteriovenous malformations (AVMs), and tumors. Many of the existing limitations of this treatment are related to the embolization agents currently available, including material compaction or migration, disease recurrence, or off-target embolization. Hydrogels are a promising class of materials that may be utilized to address some of these concerns. Methods: We compounded hydrogel formulations that were low-viscosity, shear thinning, photo-sensitive, and radioopaque. We developed a method of intravascular micro-catheter hydrogel delivery with dynamic modulation of hydrogel physical characteristics at the tip of the catheter, via photo-crosslinking with an integrated UV emitting optical fibre. This allowed for rapid transition from liquid to solid state to block blood flow at the vascular target, as well as dynamic modulation to suit the needs of a variety of neurovascular disorders. We performed preliminary testing of this novel methodology in animal models of neurovascular disease. Results: With dynamic modulation of photo-crosslinking, we were able to deliver hydrogels with a viscosity range of up to 10<^>4 Pa*s. The technique allowed for successful deposition of the hydrogel precursor in animal models for aneurysms, AVMS, and tumors. Post-procedural angiography demonstrated satisfactory occlusion of target vessels without evidence of complications. Conclusions: This novel embolization method holds promise in improving the safety and efficacy of the endovascular treatment of a variety of different pathologies and should be investigated further with direct comparative studies.