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Introduction Endovascular biopsy is a minimally invasive method for endothelial cell (EC) sampling of cerebrovascular pathologies. Prior literature has described success in intra-saccular coil biopsies for aneurysms and subsequent gene sequencing of aneurysmal ECs. However, there is high variability in the described methods for endovascular biopsies and thus difficult to reproduce amongst centers.Objective The aim of this study is to present a reproducible consistent method for endovascular biopsy that yields high quantities of intracranial ECs for gene sequencing and primary cell culture.Methods A cell extraction protocol was tested upon a variety of endovascular materials including peripheral arterial access and intracranial catheters and wires. On ice, samples were collected in 15-mL falcon tubes with a commercial cell-dissociation buffer mixed with sodium-pyruvate and heparin. Mechanical dissociation, red blood cell lysis, and column filtering were utilized to first extract ECs. Second, two antibody panels were utilized to identify ECs: (1) CD31+ CD45- and (2) CD144+ CD45-. Fluorescence-activated cell sorting (FACS) was utilized to quantify and isolate these populations. The number of ECs per sample was documented, and average EC number per sample type was documented. EC identification was also confirmed via immunohistochemistry (IHC) of von Willebrand factor (vWF) antibody. We also present preliminary evidence of primary cell culture of biopsied ECs.Results The developed protocol was tested on a total of 49 endovascular biopsies: 20 radial access samples, 20 groin access samples, and nine intracranial catheters/wires. Using the CD31+ CD45- panel, for 10 radial and 10 groin samples, there was an average of 21,339 ± 20,911 and 18,880 ± 18019 cells per sample respectively. Using the CD144+ CD45- panel, for 10 radial and 10 groin samples, there was an average of 6320 ± 9261 and 6216 ± 6093 cells per sample respectively. The nine intracranial samples which included microwires, intermediate and guide catheters from various pathologies were processed via the CD 31+ CD45- panel with an average of 26252 ± 52447 cells per sample. With an additional radial access sample, cells were also stained positive for vWF to confirm EC identification. Finally, we demonstrate a successful 30 day survival of primary culture of biopsied ECs from an access catheter confirmed via FACs.Conclusion To date, we present on average the highest number of ECs successfully isolated from endovascular biopsy allowing for sufficient for downstream gene sequencing and primary culture.Disclosures A. Liang: None. S. Dabb: None. K. Budohoski: None.Abstract E-270 Figure 2Endothelial primary cell culture of radial accessAbstract E-270 Figure 1Von Willebrand Factor antibody staining for biopsied endothelial cells