Brinjikji Waleed, Yong Hong Ding, Dai Daying, Schroeder Dana J, Kallmes David F, Kadirvel Ramanathan
Department of Radiology, Mayo Clinic, Rochester, Minnesota, USA.
J Neurointerv Surg. 2017 Feb;9(2):200-203. doi: 10.1136/neurintsurg-2016-012265. Epub 2016 Mar 3.
Owing to their anti-inflammatory effects and ability to stimulate production of extracellular matrix and chemotactic migration of mesenchymal progenitor cells, statins could potentially improve aneurysm healing after endovascular treatment.
To test the hypothesis that systemic administration of simvastatin would improve aneurysm healing in a rabbit model of unruptured intracranial aneurysms.
Experimental aneurysms were created in female rabbits and were embolized with platinum coils. Six rabbits served as controls and six rabbits received oral administration of simvastatin. Digital subtraction angiography was used to evaluate stability after embolization. Subjects were euthanized 4 weeks after coil embolization. Histologic samples were examined with a grading system (0-12) based on neck and dome features. Aneurysm occlusion data were compared using a Student t test.
No significant differences in the mean aneurysm size were found between groups. No coil compaction occurred in either group. All aneurysms in both the statin and control groups showed stable occlusion. There were no significant differences in the histologic grade of occlusion in either group (statin group 2.6±0.8 vs control group 2.7±3.2, p=0.94).
Systemic statin administration after platinum coil embolization of unruptured aneurysms in a rabbit model does not improve aneurysm occlusion rates at 4 weeks.
由于他汀类药物具有抗炎作用,且能够刺激细胞外基质的产生以及间充质祖细胞的趋化迁移,因此其有可能改善血管内治疗后的动脉瘤愈合情况。
验证在未破裂颅内动脉瘤兔模型中,全身给予辛伐他汀可改善动脉瘤愈合的假说。
在雌性兔身上制造实验性动脉瘤,并用铂金线圈进行栓塞。6只兔作为对照组,6只兔口服辛伐他汀。使用数字减影血管造影术评估栓塞后的稳定性。在弹簧圈栓塞4周后对实验对象实施安乐死。组织学样本采用基于颈部和瘤顶特征的分级系统(0-12级)进行检查。使用学生t检验比较动脉瘤闭塞数据。
两组之间的平均动脉瘤大小未发现显著差异。两组均未发生弹簧圈致密化。他汀类药物组和对照组的所有动脉瘤均显示出稳定的闭塞。两组的组织学闭塞分级均无显著差异(他汀类药物组2.6±0.8 vs对照组2.7±3.2,p=0.94)。
在兔模型中,未破裂动脉瘤进行铂金弹簧圈栓塞后全身给予他汀类药物,在4周时并未提高动脉瘤的闭塞率。