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经血管内途径对囊状动脉瘤进行电血栓形成术。第1部分:电化学基础、技术及实验结果。

Electrothrombosis of saccular aneurysms via endovascular approach. Part 1: Electrochemical basis, technique, and experimental results.

作者信息

Guglielmi G, Viñuela F, Sepetka I, Macellari V

机构信息

Department of Neurological Sciences, University of Rome Medical School, Italy.

出版信息

J Neurosurg. 1991 Jul;75(1):1-7. doi: 10.3171/jns.1991.75.1.0001.

Abstract

Eleven experimental saccular aneurysms were created on the common carotid artery of swine. Between 3 and 15 days after creation of these aneurysms, they were thrombosed via an endovascular approach, using a very soft detachable platinum coil delivered through a microcatheter positioned within the aneurysm. This detachable platinum coil was soldered to a stainless steel delivery guidewire. Intra-aneurysmal thrombosis was then initiated by applying a low positive direct electric current to the delivery guidewire. Thrombosis occurred because of the attraction of negatively charged white blood cells, red blood cells, platelets, and fibrinogen to the positively charged platinum coil positioned within the aneurysm. The passage of electric current detached the platinum coil within the clotted aneurysm in 4 to 12 minutes. This detachment was elicited by electrolysis of the stainless steel wire nearest to the thrombus-covered platinum coil. Control angiograms obtained 2 to 6 months postembolization confirmed permanent aneurysm occlusion as well as patency of the parent artery in all cases. No angiographic manifestation of untoward distal embolization was noted. Due to the encouraging results of this research, this technique has been applied in selected clinical cases which are described in Part 2 of this study.

摘要

在猪的颈总动脉上制造了11个实验性囊状动脉瘤。在这些动脉瘤形成后的3至15天内,通过血管内途径使其血栓形成,使用通过置于动脉瘤内的微导管输送的非常柔软的可脱卸铂线圈。这种可脱卸铂线圈焊接在不锈钢输送导丝上。然后通过向输送导丝施加低正直流电来启动动脉瘤内血栓形成。血栓形成是由于带负电荷的白细胞、红细胞、血小板和纤维蛋白原被吸引到位于动脉瘤内带正电荷的铂线圈上。电流通过在4至12分钟内使血栓形成的动脉瘤内的铂线圈脱卸。这种脱卸是由最靠近被血栓覆盖的铂线圈的不锈钢丝的电解引起的。栓塞后2至6个月获得的对照血管造影证实所有病例中动脉瘤均永久性闭塞且供血动脉通畅。未观察到不良远端栓塞的血管造影表现。由于这项研究的令人鼓舞的结果,该技术已应用于本研究第2部分中描述的选定临床病例。

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