Agrawal Sandeep K
Division of Neurosurgery, Department of Surgery, University of Nebraska Medical Center, Omaha, NE, USA.
Neurol Res. 2013 Jan;35(1):37-43. doi: 10.1179/1743132812Y.0000000110.
Cellular adhesion on the surface of Guglielmi detachable coils (GDC) promotes accelerated occlusion of aneurysms. We hypothesized that coils coated with transforming growth factor beta (TGF-beta) and vascular endothelial growth factor (VEGF) will promote clot organization and endothelial or cellular proliferation to facilitate closure of large experimental aneurysms relative to uncoated GDC coils.
GDC were inserted either uncoated, coated with albumin, coated with TGF-beta (500 μg/ml) or with VEGF (500 μg/ml) into the ligated common carotid artery of adult male wistar rats for 14 days. Twenty-four adult male Wistar rats (280-300 g) were divided into four groups (n = 6 per group). Subjects were killed 2 weeks after implantation and common carotid artery (CCA) segments were harvested and coils were removed. Arterial tissue was evaluated histopathologically.
Significant differences in the proportion of aneurysm luminal area (mm(2)) was shown among Group i (0·22±0·14 SD) and Group ii (0·16±0·8 SD) compared to Group iii (0·04±0·03 SD; P<0·05), and Group iv (0·02±0·02 SD; P<0·05) analyzed 2 weeks postoperatively. Light microscopy showed well organized fibrous tissue formation of epithelial cells and intimal hyperplasia around the coils when using the coated GDC's (Group iii and Group iv).
The result of this study suggests that the coated GDC with TGF-beta or VEGF appears beneficial in promoting endothelization, clot organization, and cellular tissue integration of the coils.
Guglielmi可脱卸弹簧圈(GDC)表面的细胞黏附会促进动脉瘤的加速闭塞。我们推测,与未涂层的GDC弹簧圈相比,涂有转化生长因子β(TGF-β)和血管内皮生长因子(VEGF)的弹簧圈将促进血栓形成组织化以及内皮或细胞增殖,以促进大型实验性动脉瘤的闭合。
将未涂层、涂有白蛋白、涂有TGF-β(500μg/ml)或涂有VEGF(500μg/ml)的GDC插入成年雄性Wistar大鼠结扎的颈总动脉中14天。24只成年雄性Wistar大鼠(280-300g)分为四组(每组n = 6)。植入后2周处死动物,收集颈总动脉(CCA)节段并取出弹簧圈。对动脉组织进行组织病理学评估。
术后2周分析显示,与第iii组(0.04±0.03 SD;P<0.05)和第iv组(0.02±0.02 SD;P<0.05)相比,第i组(0.22±0.14 SD)和第ii组(0.16±0.8 SD)的动脉瘤腔面积(mm²)比例存在显著差异。光学显微镜检查显示,使用涂层GDC时(第iii组和第iv组),弹簧圈周围有组织良好的上皮细胞纤维组织形成和内膜增生。
本研究结果表明,涂有TGF-β或VEGF的GDC在促进弹簧圈的内皮化、血栓形成组织化和细胞组织整合方面似乎是有益的。