Wang Jiwei, Ding Yanan, Wang Qiuxia, Wang Yanan, Mu Shiqing, Bi Lixin, Li Youxiang
Beijing Neurosurgical Institute, Capital Medical University, Beijing, China (mainland).
Department of Neurosurgery, Affiliated Hospital of Hebei University, Baoding, Hebei, China (mainland).
Med Sci Monit. 2017 Mar 23;23:1428-1435. doi: 10.12659/msm.900622.
BACKGROUND Flow-diverting stent (FDS) has been suggested as an effective intracranial aneurysm treatment. However, the effects of FDS on collateral branches of an aneurysm parent artery still remain unknown. Thus, the present study aimed to comprehensively evaluate the effects of placing a FDS in the intracranial collateral artery, using a miniature pig animal model. MATERIAL AND METHODS Ten healthy miniature pigs were included in the study: one pig was reserved as a control and the remaining nine pigs were placed in three experimental groups: FDS (i.e., Pipeline), LVIS, and Solitaier-AB stent groups. Pigs in the experimental groups were examined by cerebral angiography immediately after stent placement, followed by hemodynamic analyses. In addition, magnetic resonance imaging (MRI) of the brain of pigs in the experimental groups was performed to inspect the brain for obstruction and blood flow. Stents were examined for the growth of neointimas. RESULTS The results showed that neointimas, consisting of smooth muscle cells, collagenous fibers, and macrophages, were 0.67 mm thick on average and partially covered the stent wires. The thickness of neointimas in the FDS group was significantly higher than in the two conventional intracranial stent groups. There was no obvious obstruction identified in collateral arteries where the FDS was placed. CONCLUSIONS These results indicated that neointimas in collateral arteries of a miniature pig would be slightly thickened after one month of FDS placement; and FDS was shown to be safe for collateral arteries.
背景 血流导向支架（FDS）已被认为是一种有效的颅内动脉瘤治疗方法。然而，FDS对动脉瘤载瘤动脉侧支分支的影响仍不清楚。因此，本研究旨在使用小型猪动物模型全面评估在颅内侧支动脉中放置FDS的效果。
材料与方法 本研究纳入10只健康小型猪：1只猪作为对照，其余9只猪分为三个实验组：FDS（即Pipeline）、LVIS和Solitaier-AB支架组。实验组的猪在支架置入后立即进行脑血管造影检查，随后进行血流动力学分析。此外，对实验组猪的脑部进行磁共振成像（MRI）检查，以检查脑部有无梗阻和血流情况。检查支架新生内膜的生长情况。
结果 结果显示，新生内膜由平滑肌细胞、胶原纤维和巨噬细胞组成，平均厚度为0.67mm，部分覆盖支架丝。FDS组新生内膜厚度明显高于两个传统颅内支架组。在放置FDS的侧支动脉中未发现明显梗阻。
结论 这些结果表明，小型猪侧支动脉在放置FDS一个月后新生内膜会略有增厚；并且FDS对侧支动脉是安全的。
