Murayama Yuichi, Tateshima Satoshi, Gonzalez Nestor R, Vinuela Fernando
Division of Interventional Neuroradiology, and Leo G. Rigler Radiological Research Center, University of California, Los Angeles, USA.
Stroke. 2003 Aug;34(8):2031-7. doi: 10.1161/01.STR.0000083394.33633.C2. Epub 2003 Jul 17.
Acceleration of intra-aneurysmal clot organization and fibrosis may be a solution to preventing aneurysm recanalization after endovascular treatment. The purpose of this study was to evaluate the short-term efficacy and long-term safety of the new Matrix coil system.
Matrix coils consist of thin platinum coils covered with a bioabsorbable, polymeric material (polyglycolic acid/lactide). Fifty-two experimental aneurysms were created in 26 swine. All of the aneurysms were tightly packed with Matrix or Guglielmi detachable coils (GDC). Comparative angiographic and histopathologic data were analyzed at 2 weeks (n=14), 3 months (n=6), and 6 months (n=6) after embolization.
Three aneurysms treated with GDC ruptured despite tight packing. No recanalization or rupturing was observed in the aneurysms embolized with Matrix coils. At 14 days after embolization, the aneurysms treated with Matrix coils exhibited a more extensive area of organized thrombus when compared with the aneurysms treated with GDC (87% versus 75%, P=0.008, n=11). At 3 months, both Matrix and GDC-treated aneurysms demonstrated complete clot organization. Neck tissue thickness was higher in Matrix-treated aneurysms at 14 days and 3 months, but not at 6 months. No untoward parent artery stenosis was observed in aneurysms treated with Matrix during follow-up. The angiographic cross-sectional area of the Matrix-treated aneurysms was smaller than those treated with GDC at the 3 months.
Matrix accelerated aneurysm fibrosis and neointima formation without parent artery stenosis. The Matrix system might prevent aneurysmal recanalization after endovascular treatment of cerebral aneurysms.
促进动脉瘤内血栓组织化和纤维化可能是预防血管内治疗后动脉瘤再通的一种方法。本研究的目的是评估新型Matrix线圈系统的短期疗效和长期安全性。
Matrix线圈由覆盖有生物可吸收聚合物材料（聚乙醇酸/丙交酯）的细铂线圈组成。在26头猪身上制造了52个实验性动脉瘤。所有动脉瘤均用Matrix或Guglielmi可脱卸线圈（GDC）紧密填塞。栓塞后2周（n = 14）、3个月（n = 6）和6个月（n = 6）分析比较血管造影和组织病理学数据。
3个用GDC治疗的动脉瘤尽管填塞紧密仍破裂。用Matrix线圈栓塞的动脉瘤未观察到再通或破裂。栓塞后14天，与用GDC治疗的动脉瘤相比，用Matrix线圈治疗的动脉瘤有更广泛的机化血栓区域（87%对75%，P = 0.008，n = 11）。3个月时，用Matrix和GDC治疗的动脉瘤均显示血栓完全机化。在14天和3个月时，用Matrix治疗的动脉瘤颈部组织厚度较高，但6个月时没有。随访期间，用Matrix治疗的动脉瘤未观察到不良的载瘤动脉狭窄。3个月时，用Matrix治疗的动脉瘤的血管造影横截面积小于用GDC治疗的动脉瘤。
Matrix可加速动脉瘤纤维化和新生内膜形成，且不引起载瘤动脉狭窄。Matrix系统可能预防脑动脉瘤血管内治疗后动脉瘤再通。
