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一种用于小血管解剖结构的新型可弯曲、可回收血管内支架系统:体内初步数据。

A novel flexible, retrievable endovascular stent system for small-vessel anatomy: preliminary in vivo data.

作者信息

Doerfler Arnd, Becker Wolfgang P H, Wanke Isabel, Goericke Sophia L, Mueller K M, Blechschmid Nina, Flesser Achim, Monstadt Hermann, Forsting Michael

机构信息

Department of Neuroradiology, Institute of Diagnostic and Interventional Radiology, University of Essen Medical School, Essen, Germany.

出版信息

AJNR Am J Neuroradiol. 2005 Apr;26(4):862-8.

Abstract

BACKGROUND AND PURPOSE

This study assessed the in vivo delivery, retrievability, short-term patency, and cellular response to a new flexible endovascular stent system in a rabbit model. The stent is designed for delivery through a microcatheter and is fully retrievable with electrolytic detachment from a delivery wire.

METHODS

We successfully deployed nine stents (range of sizes, 2.5-4 mm diameter, 15-35 mm length) in six straight (carotid) and three angled (subclavian) arteries of six Chinchilla Bastard rabbits. Serial imaging was performed by using intravenous digital subtraction angiography (IVDSA), contrast-enhanced MR angiography (CEMRA), time-of-flight MR angiography (TOF), and CT-angiography 3 days and 4 weeks after stent deployment. Subjects were euthenized after 4 weeks (n = 5), and stents were removed for histologic analysis.

RESULTS

Stent deployment was feasible in all cases. After initial deployment, all stents could be fully retrieved within the microcatheter. The detachment zone and the distal stent marker were easily visible under fluoroscopy, and final detachment occurred reliably in all cases. We observed no procedural complications. Noninvasive imaging by using IVDSA, MR angiography, and CT angiography was feasible in this stent system and demonstrated all arteries patent and not narrowed at 3 days and 4 weeks, findings that were confirmed by histologic analysis.

CONCLUSION

This electrolytically detachable stent is promising as a treatment for intracranial arteries, because it can be delivered through microcatheters small enough for intracranial navigation. It is fully retrievable, thus providing greater control than currently available stents. Noninvasive imaging by using IVDSA, MR angiography, and CT angiography is feasible in this stent system and may be useful for follow-up. Further long-term data are needed.

摘要

背景与目的

本研究在兔模型中评估了一种新型柔性血管内支架系统的体内输送、可回收性、短期通畅性及细胞反应。该支架设计用于通过微导管输送,并可通过电解方式从输送导丝上完全回收。

方法

我们在6只青紫蓝杂种兔的6条直形(颈动脉)和3条成角(锁骨下动脉)动脉中成功植入了9个支架(尺寸范围为直径2.5 - 4 mm,长度15 - 35 mm)。在支架植入后3天和4周,通过静脉数字减影血管造影(IVDSA)、对比增强磁共振血管造影(CEMRA)、时间飞跃磁共振血管造影(TOF)和CT血管造影进行序列成像。4周后对5只动物实施安乐死,取出支架进行组织学分析。

结果

所有病例中支架植入均可行。初始植入后,所有支架均可在微导管内完全回收。在荧光透视下,分离区和远端支架标记易于观察,所有病例均可靠地实现了最终分离。我们未观察到手术并发症。使用IVDSA、磁共振血管造影和CT血管造影进行的无创成像在该支架系统中可行,且显示所有动脉在3天和4周时均通畅且未狭窄,组织学分析证实了这些结果。

结论

这种可电解分离的支架有望用于颅内动脉治疗,因为它可通过足够小的微导管输送以用于颅内导航。它完全可回收,因此比现有支架提供了更好的控制。使用IVDSA、磁共振血管造影和CT血管造影进行的无创成像在该支架系统中可行,可能对随访有用。需要进一步的长期数据。

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