Raymond Jean, Mounayer Charbel, Salazkin Igor, Metcalfe Annick, Gevry Guylaine, Janicki Christian, Roorda Sjoerd, Leblanc Philippe
Centre hospitalier de l'Université de Montréal--Hôpital Notre Dame, Interventional Neuroradiology Research laboratory, 1560 Sherbrooke E, Suite M-8203, Montreal, Quebec, Canada H2L 4M1.
Stroke. 2006 Aug;37(8):2147-52. doi: 10.1161/01.STR.0000231724.18357.68. Epub 2006 Jun 29.
Recanalization after coil embolization can be prevented by radiation emitted from 32P coils. We wanted to determine the upper limits of 32P activities that could be implanted onto coils with respect to the potential injury to nearby nerves, delay in organization of the clot, and effects on neointima formation and recanalization.
We studied the effects of various 32P activities on recanalization and organization of thrombus after coil occlusion of canine arteries and on neointima formation at the neck of canine carotid bifurcation aneurysms. We also tested potential injury to nerves in the vicinity of radioactive or nonradioactive coils in 3 models: the brachial plexus (near proximal vertebral arteries) and the lingual nerve in a lingual artery bifurcation aneurysm model, both models being treated by radioactive or standard coil occlusion. Finally, we wrapped lingual nerves with nonradioactive or high-activity coils and studied their effects on lingual nerves and tongues. Results were assessed with a pathological scoring system and compared with Mann-Whitney and Kruskal-Wallis tests.
No deleterious effect of radiation on nerves could be detected. Neointima formation was not hampered, scores of aneurysms treated with 32P-coils being significantly better when compared with treatments with standard coils (P=0.002). Arteries treated with high-activity coils (>3.39 microCi) showed absent recanalization but delayed organization of the clot at 3 months compared with low-activity or nonradioactive coils (P<0.05).
beta-Radiation can prevent recanalization after coil occlusion. We could not demonstrate any deleterious effects of radioactivity on nervous structure or on neointima formation. Delayed organization of thrombus provides a rational basis to establish an upper limit for 32P activities to be implanted onto coils.
32P 线圈发出的辐射可防止线圈栓塞后再通。我们想要确定植入到线圈上的 32P 活度上限，这与对附近神经的潜在损伤、血栓机化延迟以及对新生内膜形成和再通的影响有关。
我们研究了各种 32P 活度对犬动脉线圈闭塞后血栓再通和机化以及犬颈动脉分叉动脉瘤颈部新生内膜形成的影响。我们还在 3 个模型中测试了放射性或非放射性线圈附近神经的潜在损伤：臂丛神经（靠近椎动脉近端）和舌动脉分叉动脉瘤模型中的舌神经，这两个模型均采用放射性或标准线圈闭塞治疗。最后，我们用非放射性或高活度线圈包裹舌神经，并研究它们对舌神经和舌头的影响。结果采用病理评分系统进行评估，并与 Mann-Whitney 检验和 Kruskal-Wallis 检验进行比较。
未检测到辐射对神经有有害影响。新生内膜形成未受阻碍，与标准线圈治疗相比，用 32P 线圈治疗的动脉瘤评分明显更好（P = 0.002）。与低活度或非放射性线圈相比，用高活度线圈（>3.39 微居里）治疗的动脉在 3 个月时未出现再通，但血栓机化延迟（P<0.05）。
β 辐射可防止线圈闭塞后再通。我们未能证明放射性对神经结构或新生内膜形成有任何有害影响。血栓机化延迟为确定植入到线圈上的 32P 活度上限提供了合理依据。
