Department of Neurology, University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA.
Department of Pathology and Laboratory Medicine, University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA.
World Neurosurg. 2021 Apr;148:e242-e251. doi: 10.1016/j.wneu.2020.12.134. Epub 2021 Jan 4.
Aneurysmal subarachnoid hemorrhage remains a devastating event with poorly understood pathophysiology. Previous studies have suggested that aneurysm wall inflammation may play a part in the development and potential rupture of aneurysms. The rabbit elastase aneurysm model is a well-established model, which produces aneurysms closely mimicking human cerebral aneurysms in flow dynamics and histopathology. The primary aim of this study was to correlate inflammatory changes after aneurysm formation using sequential vessel wall imaging with histopathologic analysis. A secondary aim was to evaluate the potential effect of gender and anti-inflammatory treatment with aspirin on this inflammatory response.
Twenty-seven New Zealand rabbits underwent surgery to create an aneurysm using elastase infusion at the right common carotid artery origin. Vessel wall imaging and histopathologic analysis was obtained at different time points after aneurysm creation. The rabbits were also randomized by gender and to treatment groups with or without aspirin.
Histopathologic analysis revealed 3 distinct phases after aneurysm formation. These phases were an initial inflammatory phase, followed by a regeneration phase, and finally a connective tissue deposition phase. Vessel wall imaging demonstrated 2 distinct imaging patterns. No appreciable differences were seen in histology or imaging when comparing gender or treatment with aspirin.
Inflammatory changes induced by the rabbit elastase aneurysm model can be correlated with histopathologic findings and observed on noninvasive vessel wall imaging. This may provide a method to study the inflammatory pathway as it pertains to aneurysmal development and subsequent rupture.
尽管蛛网膜下腔出血的病理生理学仍未被完全理解,但它仍是一种破坏性很强的疾病。先前的研究表明,动脉瘤壁炎症可能在动脉瘤的发展和潜在破裂中起作用。兔弹性蛋白酶动脉瘤模型是一种成熟的模型,它产生的动脉瘤在血流动力学和组织病理学上与人类脑动脉瘤非常相似。本研究的主要目的是通过对形成后的血管壁进行连续成像来对炎症变化进行相关性分析,并结合组织病理学分析。次要目的是评估性别和阿司匹林抗炎治疗对这种炎症反应的潜在影响。
27 只新西兰兔接受手术,在右侧颈总动脉起点处用弹性蛋白酶注入来形成动脉瘤。在形成动脉瘤后不同时间点进行血管壁成像和组织病理学分析。兔子还按性别和是否用阿司匹林进行治疗分组进行随机分组。
组织病理学分析显示,动脉瘤形成后有 3 个不同的阶段。这些阶段分别是初始炎症期,接着是再生期,最后是结缔组织沉积期。血管壁成像显示出 2 种不同的成像模式。在比较性别或用阿司匹林进行治疗时,在组织学或影像学上没有明显差异。
兔弹性蛋白酶动脉瘤模型引起的炎症变化可以与组织病理学发现相关,并在非侵入性血管壁成像上观察到。这可能为研究与动脉瘤发展和随后破裂相关的炎症途径提供了一种方法。