Stroke and Cerebrovascular Center, Department of Neurosciences, Medical University of South Carolina, 96 Jonathan Lucas Street, Suite 428 CSB, Charleston, SC 29466, USA.
J Neurointerv Surg. 2011 Sep;3(3):214-8. doi: 10.1136/jnis.2010.003913. Epub 2011 Jan 25.
Current models for the endovascular treatment of aneurysms often require the use of adjuvant devices. Balloon-assisted techniques require temporary occlusion of the parent vessel. Intravascular stents require the use of antiplatelet medication. A novel device that achieves temporary neck protection without parent vessel occlusion or antiplatelet medication is examined in a canine model.
20 sidewall wide-necked aneurysms were created in 10 canines, one in each carotid artery, using a vein graft technique, and allowed to mature. In each canine, one aneurysm was catheterized with a microcatheter while the neck protection device (NPD) was unsheathed across the neck of the aneurysm and the aneurysm was coiled. The second aneurysm in each canine was coiled without an adjunctive device. The NPD was assessed for coil herniation, coil entrapment within the device, deployability and retrievability. Five animals were killed immediately and five were killed at 28 days and the carotid artery was explanted and sent for necropsy to assess for injury to the endothelium.
All aneurysms were successfully treated with no adverse events. The NPD was well visualized and unsheathed and resheathed successfully in all cases. There was no coil entrapment within the device, and there were no cases of coil herniation. There was no evidence of endothelial injury or dissection.
The device was technically successful in all devices and further development of this device may be of benefit in endovascular treatment of aneurysms.
目前用于治疗动脉瘤的血管内治疗模型通常需要使用辅助装置。球囊辅助技术需要暂时阻断母血管。血管内支架需要使用抗血小板药物。本研究通过犬模型来检验一种新型的临时保护装置，该装置在不阻断母血管或使用抗血小板药物的情况下实现临时颈部保护。
10 只犬的每侧颈总动脉各形成 1 个侧壁宽颈动脉瘤，采用静脉移植物技术，使其成熟。在每只犬中，使用微导管对其中 1 个动脉瘤进行导管治疗，同时将颈保护装置（NPD）穿过动脉瘤颈部展开，并对动脉瘤进行线圈栓塞。每只犬的另一个动脉瘤则不使用辅助装置进行线圈栓塞。评估 NPD 的线圈突出、线圈嵌顿、可展开性和可回收性。立即处死 5 只动物，28 天后处死 5 只动物，取出颈总动脉并进行尸检，评估内皮损伤。
所有动脉瘤均成功治疗，无不良事件发生。所有情况下，NPD 均能很好地显影，并能成功展开和收回。没有线圈嵌顿在装置内，也没有线圈突出的情况。没有内皮损伤或夹层的证据。
该装置在所有装置中均取得了技术成功，这种装置的进一步开发可能对动脉瘤的血管内治疗有益。
