Roth C, Struffert T, Grunwald I Q, Romeike B F M, Krick C, Papanagiotou P, Krampe P, Reith W
Department of Diagnostic and Interventional Neuroradiology, University of the Saarland, Homburg, Germany.
Neuroradiology. 2008 Aug;50(8):693-9. doi: 10.1007/s00234-008-0392-8. Epub 2008 May 29.
The aim of the study was to compare standard platinum Guglielmi detachable coils (GDC) with coated platinum coils (Matrix; both Boston Scientific, Fremont, CA) regarding handling, complications, occlusion and recanalization rate after 3 and 6A months.
Aneurysms in the right common carotid artery were created in 25 rabbits. The animals were divided into five groups of five animals each. The animals of group 1 (the control group) received no treatment of the induced aneurysms, the animals of groups 2 and 3 (killed at 3 and 6A months) were treated with standard GDC, and the animals of groups 4 and 5 (killed at 3 and 6A months) were treated with Matrix coils.
Histopathological evaluation showed organized thrombus formation and connective tissue with neovascularization around the implanted coils in all the treated groups. The achieved occlusion rates in groups 2 and 3 were identical to those in groups 4 and 5. Thus the long-term results of aneurysm treatment with GDC and Matrix coils show no differences regarding occlusion and recanalization rates. The only noticeable difference was the difference in handling. More force was required to pushing the Matrix coils forward through the microcatheter and there was more friction in coil interaction in the aneurysm.
The bioactive coating of the Matrix coil produces no significant benefit in achieving higher occlusion and lower recanalization rates, and the coil is more difficult to handle. Future bioactive coils must be shown to produce significantly better long-term results than GDC and their ease of handling has to be improved.
本研究的目的是比较标准铂制 Guglielmi 可解脱弹簧圈(GDC)与涂层铂制弹簧圈(Matrix;均为波士顿科学公司,加利福尼亚州弗里蒙特)在操作、并发症、闭塞情况以及 3 个月和 6 个月后的再通率方面的差异。
在 25 只兔子的右侧颈总动脉中制造动脉瘤。将动物分为五组,每组五只。第 1 组(对照组)对诱发的动脉瘤不进行治疗,第 2 组和第 3 组(分别在 3 个月和 6 个月时处死)用标准 GDC 治疗,第 4 组和第 5 组(分别在 3 个月和 6 个月时处死)用 Matrix 弹簧圈治疗。
组织病理学评估显示,在所有治疗组中,植入的弹簧圈周围均有组织化血栓形成以及伴有新生血管的结缔组织。第 2 组和第 3 组的闭塞率与第 4 组和第 5 组相同。因此,用 GDC 和 Matrix 弹簧圈治疗动脉瘤的长期结果在闭塞率和再通率方面没有差异。唯一明显的差异在于操作方面。将 Matrix 弹簧圈通过微导管向前推送需要更大的力,并且在动脉瘤内弹簧圈相互作用时摩擦力更大。
Matrix 弹簧圈的生物活性涂层在实现更高的闭塞率和更低的再通率方面没有显著益处,并且该弹簧圈更难操作。未来的生物活性弹簧圈必须证明其长期效果明显优于 GDC,并且其操作便利性必须得到改善。