Padolecchia R, Guglielmi G, Puglioli M, Castagna M, Nardini V, Collavoli P L, Guidetti G, Dazzi M, Zucchi V, Narducci P
Section of Neuroradiology, S. Chiara Hospital, Pisa, Italy.
AJNR Am J Neuroradiol. 2001 Oct;22(9):1757-60.
In the 1990s, the introduction of the Guglielmi detachable coil (GDC) system in clinical practice was followed by extensive clinical use of this endovascular device in the treatment of brain aneurysms. This technology is based on electrothrombosis and electrolytic detachment of platinum coils. Despite the extensive use of this treatment technique, the role of electrothrombosis has not been fully investigated and clarified. An in vitro electron microscopic study of human blood was performed to elucidate the role that electrothrombosis might play in triggering the biologic response of thrombosis of the aneurysmal sac.
Human blood from five patients was used to fill plastic containers in which GDCs had been deposited. These five patients had subarachnoid hemorrhage and were similar in age and clinical presentation. Electron microscopic studies were performed on GDCs that had been electrically charged and on GDCs that had not.
All electron microscopic studies revealed that the electrically charged GDCs were covered by blood elements and fibrin adherent to the surface of the coil. Noncharged GDCs did not have deposits or adhesions of these blood constituents.
These findings demonstrated that passage of electric current through the GDC induces attraction of blood constituents. This attraction may trigger a thrombotic reaction on the surface of the coil. The greater the time of current application, the more pronounced the cellular reaction and the deposition of fibrin and blood cells on the GDC.
20世纪90年代， Guglielmi可脱性弹簧圈（GDC）系统引入临床实践后，这种血管内装置在脑动脉瘤治疗中得到了广泛的临床应用。该技术基于铂弹簧圈的电凝血栓形成和电解分离。尽管这种治疗技术被广泛应用，但其电凝血栓形成的作用尚未得到充分研究和阐明。进行了一项人体血液的体外电子显微镜研究，以阐明电凝血栓形成在引发动脉瘤囊血栓形成的生物学反应中可能发挥的作用。
使用5名患者的血液填充已放置GDC的塑料容器。这5名患者均有蛛网膜下腔出血，年龄和临床表现相似。对已充电和未充电的GDC进行电子显微镜研究。
所有电子显微镜研究均显示，带电的GDC被附着在弹簧圈表面的血液成分和纤维蛋白覆盖。未带电的GDC没有这些血液成分的沉积或附着。
这些发现表明，电流通过GDC会诱导血液成分的吸引。这种吸引可能会引发弹簧圈表面的血栓形成反应。电流施加时间越长，细胞反应以及纤维蛋白和血细胞在GDC上的沉积就越明显。
