动脉瘤内血流分流器诱导血栓形成的体外评估：一项可行性研究。
In Vitro Evaluation of Intra-Aneurysmal, Flow-Diverter-Induced Thrombus Formation: A Feasibility Study.
作者信息
Gester K, Lüchtefeld I, Büsen M, Sonntag S J, Linde T, Steinseifer U, Cattaneo G
机构信息
From the Department of Cardiovascular Engineering (K.G., I.L., M.B., S.J.S., T.L., U.S.), Institute of Applied Medical Engineering, Helmholtz Institute-RWTH Aachen University, Aachen, Germany
From the Department of Cardiovascular Engineering (K.G., I.L., M.B., S.J.S., T.L., U.S.), Institute of Applied Medical Engineering, Helmholtz Institute-RWTH Aachen University, Aachen, Germany.
出版信息
AJNR Am J Neuroradiol. 2016 Mar;37(3):490-6. doi: 10.3174/ajnr.A4555. Epub 2015 Oct 8.
BACKGROUND AND PURPOSE
Intracranial aneurysm treatment by flow diverters aims at triggering intra-aneurysmal thrombosis. By combining in vitro blood experiments with particle imaging velocimetry measurements, we investigated the time-resolved thrombus formation triggered by flow diverters.
MATERIALS AND METHODS
Two test setups were built, 1 for particle imaging velocimetry and 1 for blood experiments, both generating the same pulsatile flow and including a silicone aneurysm model. Tests without flow diverters and with 2 different flow-diverter sizes (diameter: 4.5 and 4.0 mm) were performed. In the blood experiments, the intra-aneurysmal flow was monitored by using Doppler sonography. The experiments were stopped at 3 different changes of the spatial extent of the signal.
RESULTS
No thrombus was detected in the aneurysm model without the flow diverter. Otherwise, thrombi were observed in all aneurysm models with flow diverters. The thrombi grew from the proximal side of the aneurysm neck with fibrin threads connected to the flow diverter and extending across the aneurysm. The thrombus resulting from the 4.0-mm flow diverter grew along the aneurysm wall as a solid and organized thrombus, which correlates with the slower velocities near the wall detected by particle imaging velocimetry. The thrombus that evolved by using the 4.5-mm flow diverter showed no identifiable growing direction. The entire thrombus presumably resulted from stagnation of blood and correlates with the central vortex detected by particle imaging velocimetry.
CONCLUSIONS
We showed the feasibility of in vitro investigation of time-resolved thrombus formation in the presence of flow diverters.
背景与目的
血流导向装置治疗颅内动脉瘤旨在引发瘤内血栓形成。通过将体外血液实验与粒子成像测速测量相结合，我们研究了血流导向装置引发的血栓形成的时间分辨情况。
材料与方法
构建了两种测试装置，一种用于粒子成像测速，一种用于血液实验，两者均产生相同的脉动血流，并包含一个硅橡胶动脉瘤模型。进行了无血流导向装置以及两种不同尺寸（直径分别为4.5和4.0毫米）血流导向装置的测试。在血液实验中，使用多普勒超声监测瘤内血流。实验在信号空间范围的3个不同变化点停止。
结果
在没有血流导向装置的动脉瘤模型中未检测到血栓。否则，在所有有血流导向装置的动脉瘤模型中均观察到血栓。血栓从动脉瘤颈部近端生长，有纤维蛋白丝连接到血流导向装置并延伸穿过动脉瘤。由4.0毫米血流导向装置形成的血栓沿着动脉瘤壁生长为坚实且有组织的血栓，这与粒子成像测速检测到的靠近壁面处较慢的流速相关。使用4.5毫米血流导向装置形成的血栓没有可识别的生长方向。整个血栓可能是由血液停滞导致的，这与粒子成像测速检测到的中心涡流相关。
结论
我们展示了在有血流导向装置的情况下对血栓形成进行时间分辨的体外研究的可行性。
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