Onizuka M, Miskolczi L, Gounis M J, Seong J, Lieber B B, Wakhloo A K
Department of Neurosurgery, Fukuoka University Chikushi Hospital, Fukuoka, Japan.
AJNR Am J Neuroradiol. 2006 May;27(5):1129-31.
Elastase-induced aneurysms in rabbits have become an accepted model to study endovascular treatment. The size and shape of the resulting aneurysms may vary widely. Our goal was to predict the final aneurysm morphology on the basis of immediate postinduction geometry.
Thirty New Zealand white rabbits were used. Aneurysms were created at the origin of the right common carotid artery (CCA). Intraluminal incubation of elastase was applied to the origin of CCA with proximal balloon occlusion of the artery. The aneurysms were allowed to mature for 3 weeks and evaluated by digital subtraction angiography. We retrospectively measured neck diameter, dome height, and aneurysm diameter, as well as the angle between the parent artery and the main axis of the aneurysm neck. We performed correlation analysis with immediate postinduction geometry.
The diameter of the origin of the CCA measured immediately after elastase incubation correlated positively to the mature aneurysm neck (P < .01). Moreover, the aneurysm neck both after the aneurysm creation and at 3-week follow-up had a positive correlation with the final dome height (P < .05). Finally, the dome height was related to the angle between the centerline of the innominate artery and axis of the aneurysm neck for dome diameter-to-neck ratio of <1.5 (P < .05).
These results indicate that neck width immediately after creation and the curvature of the parent artery are linked to the final aneurysm dimensions, and we may be able to predict the size of aneurysm on the day of creation.
兔弹性蛋白酶诱导性动脉瘤已成为研究血管内治疗的公认模型。所形成动脉瘤的大小和形状可能差异很大。我们的目标是根据诱导后即刻的几何形状预测最终的动脉瘤形态。
使用30只新西兰白兔。在右颈总动脉(CCA)起始处制造动脉瘤。将弹性蛋白酶腔内孵育应用于CCA起始处,并对动脉近端进行球囊闭塞。使动脉瘤成熟3周,然后通过数字减影血管造影进行评估。我们回顾性测量了瘤颈直径、瘤顶高度、动脉瘤直径,以及母动脉与动脉瘤瘤颈主轴之间的夹角。我们对诱导后即刻的几何形状进行了相关性分析。
弹性蛋白酶孵育后即刻测量的CCA起始处直径与成熟动脉瘤瘤颈呈正相关(P <.01)。此外,动脉瘤形成后及3周随访时的瘤颈与最终瘤顶高度均呈正相关(P <.05)。最后,对于瘤顶直径与瘤颈直径之比<1.5的情况,瘤顶高度与无名动脉中心线和动脉瘤瘤颈轴线之间的夹角相关(P <.05)。
这些结果表明,动脉瘤形成后即刻的瘤颈宽度和母动脉的曲率与最终的动脉瘤尺寸相关,并且我们或许能够在动脉瘤形成当天预测其大小。