Mitome-Mishima Yumiko, Oishi Hidenori, Yamamoto Munetaka, Yatomi Kenji, Nonaka Senshu, Miyamoto Nobukazu, Urabe Takao, Arai Hajime
Department of Neurosurgery, Juntendo University School of Medicine, Tokyo, Japan.
Department of Neurosurgery, Juntendo University School of Medicine, Tokyo, Japan; Department of Neuroendovascular Therapy, Juntendo University School of Medicine, Tokyo, Japan.
J Neuroradiol. 2016 Feb;43(1):43-50. doi: 10.1016/j.neurad.2015.04.003. Epub 2015 May 27.
Recanalization of post-embolization cerebral aneurysms remains a serious problem that influences treatment outcomes. Matrix2 is a bioactive, bio-absorbable, detachable coil that was developed to reduce the risk of recanalization. We examined the short-term efficacy of the Matrix2 coil system, and evaluated the temporal profile of tissue proliferation in a swine experimental aneurysm model compared with the bare platinum (BP) coil.
Thirty-six experimental aneurysms were created in 18 swine. All aneurysms were tightly packed with Matrix2 or BP coils. Comparative histologic and morphologic analyses were undertaken 1, 2 and 4 weeks post-embolization.
Endothelial-like cells were observed partially lining the aneurysmal opening one week post-embolization with both coil types. At two and four weeks post-embolization, the aneurysms treated with Matrix2 coils had more extensive areas of organized thrombus than those packed with BP coils, but the numbers of functional proliferating endothelial cells identified by immunohistochemistry in the tissue were broadly comparable between the groups. Moreover, morphological analysis suggested there were more mature endothelial cells in aneurysms treated with bare platinum rather than Matrix2 coils.
Our results indicate that aneurysms embolized with Matrix2 coils build thicker scaffolds for endothelialization, but this is not necessarily evidence of earlier tissue proliferation and maturation than those embolized with BP coils. Matrix2 coils may not be superior to BP coils for preventing aneurysmal recanalization after endovascular treatment of cerebral aneurysms.
栓塞后脑动脉瘤的再通仍然是一个影响治疗效果的严重问题。Matrix2是一种生物活性、可生物吸收的可解脱弹簧圈,其研发目的是降低再通风险。我们研究了Matrix2弹簧圈系统的短期疗效,并在猪实验性动脉瘤模型中与裸铂金(BP)弹簧圈比较,评估了组织增殖的时间进程。
在18头猪身上制造了36个实验性动脉瘤。所有动脉瘤均用Matrix2或BP弹簧圈紧密填塞。栓塞后1、2和4周进行组织学和形态学比较分析。
栓塞后1周,两种类型弹簧圈栓塞的动脉瘤开口处均可见部分内皮样细胞衬里。栓塞后2周和4周,用Matrix2弹簧圈治疗的动脉瘤形成的有组织血栓区域比用BP弹簧圈填塞的动脉瘤更广泛,但两组间通过免疫组织化学鉴定的组织中功能性增殖内皮细胞数量大致相当。此外,形态学分析表明,裸铂金弹簧圈治疗的动脉瘤中内皮细胞比Matrix2弹簧圈治疗的更成熟。
我们的结果表明,用Matrix2弹簧圈栓塞的动脉瘤为内皮化构建了更厚的支架,但这不一定表明比用BP弹簧圈栓塞的动脉瘤组织增殖和成熟更早。在脑动脉瘤血管内治疗后预防动脉瘤再通方面,Matrix2弹簧圈可能并不优于BP弹簧圈。