Department of Neurosurgery, Radboud University Medical Center, Nijmegen, The Netherlands.
Department of Pathology, Radboud University Medical Center, Nijmegen, The Netherlands.
Neurosurgery. 2019 Mar 1;84(3):804-810. doi: 10.1093/neuros/nyy092.
It is assumed that high pore densities in flow diverters (FDs) are beneficial for intracranial aneurysm (IA) healing. However, various animal studies are not conclusive on the issue, suggesting that other factors are in play. One important factor might be wall apposition.
To (1) determine the relationship between FD pore density and aneurysm occlusion, and (2) determine the relationship between FD wall apposition and aneurysm occlusion.
Saccular aneurysms were microsurgically created in the aorta of 36 Wistar rats. Twelve rats received a low pore density FD (10 pores/mm2), 12 rats received a high pore density FD (23 pores/mm2), and the remaining 12 rats served as a control group. Six animals from each group were sacrificed 1 and 3 mo after surgery. We determined aneurysm occlusion, the number of struts not in contact with the aorta wall, and the average distance from malapposed struts to aorta wall through histology.
No significant differences were found in aneurysm occlusion between the low pore density and high pore density groups (P > .05) after 1 and 3 mo of follow-up. The average number of malapposed struts was lower for the occluded aneurysm group (4.4 ± 1.9) compared to the nonoccluded aneurysm group (7.7 ± 2.6, P < .01). The average distance between malapposed struts and parent artery wall was lower for the occluded aneurysm group (33.9 μm ± 11.5 μm) than for the nonoccluded aneurysm group (48.7 μm ± 18.8 μm, P < .05).
Wall apposition is more important than pore density for aneurysm occlusion.
人们认为血流导向装置（FD）的高孔隙密度有利于颅内动脉瘤（IA）的愈合。然而，各种动物研究对此问题没有定论，这表明还有其他因素在起作用。一个重要的因素可能是贴壁。
（1）确定 FD 孔隙密度与动脉瘤闭塞之间的关系，（2）确定 FD 壁贴壁与动脉瘤闭塞之间的关系。
通过在 36 只 Wistar 大鼠的主动脉中显微手术创建囊状动脉瘤。12 只大鼠接受低孔隙密度 FD（10 个孔/mm2），12 只大鼠接受高孔隙密度 FD（23 个孔/mm2），其余 12 只大鼠作为对照组。每组有 6 只动物在手术后 1 个月和 3 个月时被处死。我们通过组织学确定了动脉瘤闭塞、未与主动脉壁接触的支柱数量以及未贴壁支柱与主动脉壁之间的平均距离。
在 1 个月和 3 个月的随访中，低孔隙密度组和高孔隙密度组之间的动脉瘤闭塞没有显著差异（P>.05）。闭塞性动脉瘤组的未贴壁支柱的平均数量（4.4±1.9）低于非闭塞性动脉瘤组（7.7±2.6，P<.01）。闭塞性动脉瘤组的未贴壁支柱与母动脉壁之间的平均距离（33.9μm±11.5μm）低于非闭塞性动脉瘤组（48.7μm±18.8μm，P<.05）。
对于动脉瘤闭塞，壁贴壁比孔隙密度更为重要。
