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新型含水凝胶填充弹簧圈在实验性兔动脉瘤中的长期血管造影和组织学结果。

Long-term angiographic and histological results of a new hydrogel-containing filling coil in experimental rabbit aneurysms.

作者信息

Killer M, Kallmes D, Jones R, Ding Y, Vestal M, Hauser T, Virmani R, Cruise G

机构信息

Department of Neurology/Neuroscience Institute, Paracelsus Medical University, Christian Doppler Clinic, Salzburg, Austria.

出版信息

Minim Invasive Neurosurg. 2010 Jun;53(3):97-105. doi: 10.1055/s-0030-1252059. Epub 2010 Aug 31.

Abstract

BACKGROUND

The aim of this study was to compare the performance of a new filling coil, the HydroFill device, to historical results of HydroSoft and bare platinum coil devices in experimental rabbit aneurysms.

METHODS

Experimental aneurysms were constructed in rabbits and embolized with HydroFill (n=32), HydroSoft (n=48), or bare platinum coil (n=47) devices. Angiographic occlusion was evaluated post-treatment and at 1 month (n=55), 3 month (n=20), 6 month (n=35), and 12 month (n=12) follow-ups according to the Raymond scale. The aneurysms were analyzed histologically for neointima formation, thrombus organization, and inflammation. Continuous and discrete results were compared using ANOVA/t-test and chi (2) tests, respectively.

RESULTS

Volumetric occlusion of the aneurysm sac was increased in the HydroFill group compared to the HydroSoft and platinum coil groups. Protrusions into the parent artery were common in all treatment groups due to the treatment of wide-necked aneurysms without the use of balloons or stents. Although angiographic occlusion post-treatment scores were reduced in the HydroFill group compared to the HydroSoft and platinum coil groups, stable/progressive occlusion was increased in the HydroFill group compared to the platinum coil group. Histologically, neointima formation and thrombus organization scores were increased in the HydroFill and HydroSoft groups compared to the platinum coil group at 3 months. Although there were some differences in the scoring, inflammation was generally minimal to mild in all three groups.

CONCLUSION

The HydroFill device, with its high levels of volumetric filling, increased stable/progressive occlusion at follow-up, increased neointima formation, and increased thrombus organization, shows promise for clinical use.

摘要

背景

本研究的目的是将一种新型填充线圈——HydroFill装置,与HydroSoft和裸铂线圈装置在实验性兔动脉瘤中的既往结果进行比较。

方法

在兔体内构建实验性动脉瘤,并用HydroFill装置(n = 32)、HydroSoft装置(n = 48)或裸铂线圈装置(n = 47)进行栓塞。治疗后以及在1个月(n = 55)、3个月(n = 20)、6个月(n = 35)和12个月(n = 12)随访时,根据Raymond分级评估血管造影闭塞情况。对动脉瘤进行组织学分析,以评估新生内膜形成、血栓机化和炎症情况。分别使用方差分析/t检验和卡方检验比较连续和离散结果。

结果

与HydroSoft组和铂线圈组相比,HydroFill组动脉瘤囊的体积闭塞增加。由于治疗宽颈动脉瘤时未使用球囊或支架,所有治疗组均常见向载瘤动脉内突出的情况。虽然与HydroSoft组和铂线圈组相比,HydroFill组治疗后的血管造影闭塞评分降低,但与铂线圈组相比,HydroFill组稳定/进展性闭塞增加。组织学上,与铂线圈组相比,3个月时HydroFill组和HydroSoft组的新生内膜形成和血栓机化评分增加。尽管评分存在一些差异,但所有三组的炎症一般都很轻微。

结论

HydroFill装置具有高水平的体积填充、随访时增加稳定/进展性闭塞、增加新生内膜形成和增加血栓机化,显示出临床应用前景。

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