Tamatani S, Ozawa T, Minakawa T, Takeuchi S, Koike T, Tanaka R
Department of Neurosurgery, Brain Research Institute, Niigata University, Japan.
AJNR Am J Neuroradiol. 1999 Apr;20(4):541-5.
Platinum coil embolization is one of the significant advances in interventional neuroradiologic techniques that has been introduced this decade. Our purpose was to evaluate the angiographic and histologic effects of collagen-coated platinum microcoil delivery in the canine artery.
We embolized the bilateral internal maxillary arteries of 18 dogs; one uncoated and one collagen-primed coil was used in each dog. We evaluated all coils by angiography, macroscopy, and scanning electron microscopy within 30 minutes of embolization. We then studied a proportional number of coated and collagen-primed coils at either 1 or 3 days, or 1, 2, 3, 4, 8, 12, or 16 weeks postoperatively.
Six (33%) of 18 arteries embolized with uncoated coils were occluded 30 minutes after delivery, whereas 11 (61%) of 18 arteries treated with collagen-primed coils were occluded within 30 minutes of embolization. Late occlusion (3 weeks after embolization) occurred in 2 (25%) of 8 arteries embolized with untreated coils, and 6 (75%) of 8 arteries embolized with collagen-primed coils. We calculated differences in late occlusion rates by the chi2 (chi-square) test, and found these differences were significant (P=.04). Histologic findings of arteries embolized with unprimed coils revealed endothelial cell growth was limited to the organized thrombi 4 weeks after coil delivery. In contrast, endothelial cells grew directly on the collagen-primed coils 3 days postoperatively, and coils were completely covered by endothelial cells within 2 weeks. We found an organized thrombus in the inner space of coils in angiographically occluded arteries, a finding that was not evident in angiographically patent arteries.
Collagen-coated platinum coils can produce rapid and stable occlusion of embolized vessels.
铂金线圈栓塞术是近十年来介入神经放射学技术的重大进展之一。我们的目的是评估胶原涂层铂金微线圈在犬动脉中的血管造影和组织学效果。
我们栓塞了18只犬的双侧上颌内动脉；每只犬使用一个未涂层和一个胶原预处理的线圈。在栓塞后30分钟内，通过血管造影、大体观察和扫描电子显微镜对所有线圈进行评估。然后在术后1天或3天，或1、2、3、4、8、12或16周，对一定比例的涂层和胶原预处理线圈进行研究。
18条用未涂层线圈栓塞的动脉中有6条（33%）在输送后30分钟闭塞，而18条用胶原预处理线圈治疗的动脉中有11条（61%）在栓塞后30分钟内闭塞。用未处理线圈栓塞的8条动脉中有2条（25%）发生晚期闭塞（栓塞后3周），用胶原预处理线圈栓塞的8条动脉中有6条（75%）发生晚期闭塞。我们通过卡方检验计算晚期闭塞率的差异，发现这些差异具有统计学意义（P = 0.04）。未预处理线圈栓塞动脉的组织学结果显示，线圈输送4周后，内皮细胞生长仅限于有组织的血栓。相比之下，术后3天内皮细胞直接在胶原预处理线圈上生长，2周内线圈被内皮细胞完全覆盖。我们在血管造影显示闭塞的动脉的线圈内部空间发现有组织的血栓，这一发现在血管造影显示通畅的动脉中不明显。
胶原涂层铂金线圈可使栓塞血管快速、稳定地闭塞。
