Department of Neurosurgery, All India Institute of Medical Sciences, Saket Nagar, Bhopal 462020, Madhya Pradesh, India.
Department of Neurosurgery, All India Institute of Medical Sciences, Bhopal, India.
J Stroke Cerebrovasc Dis. 2021 Jun;30(6):105737. doi: 10.1016/j.jstrokecerebrovasdis.2021.105737. Epub 2021 Mar 25.
Aneurysmal subarachnoid Hemorrhage is a major cause of neurological morbidity and mortality. Over the years vascular neurosurgery has witnessed technological advances aimed to reduce the morbidity and mortality. Several endovascular devices have been used in clinical practice to achieve this goal in the management of ruptured and unruptured cerebral aneurysms. Recurrence due to recanalization is encountered in all of these endovascular devices as well as illustrated by Barrow Ruptured Aneurysm Trial. Histological and molecular characterization of the aneurysms treated with endovascular devices is an area of active animal and human research studies. Yet, the pathobiology illustrating the mechanisms of aneurysmal occlusion and healing lacks evidence. The enigma of aneurysmal healing following treatment with endovascular devices needs to be de-mystified to understand the biological interaction of endovascular device and aneurysm and thereby guide the future development of endovascular devices aimed at better aneurysm occlusion. We performed a comprehensive and detailed literature review to bring all the known facts of the pathobiology of intracranial aneurysm healing, the knowledge of which is of paramount importance to neurosurgeons, an interventional neuroradiologist, molecular biologist, geneticists, and experts in animal studies. This review serves as a benchmark of what is known and platform for future studies basic science research related to intracranial aneurysms.
血管内治疗后的愈合谜团
颅内动脉瘤破裂是一种严重的致残和致死性疾病。多年来，血管神经外科学见证了旨在降低发病率和死亡率的技术进步。在破裂和未破裂脑动脉瘤的治疗中，已经在临床实践中使用了几种血管内装置来实现这一目标。所有这些血管内装置都存在再通导致的复发，正如巴罗破裂动脉瘤试验所表明的那样。用血管内装置治疗的动脉瘤的组织学和分子特征是动物和人类研究的活跃领域。然而，阐明动脉瘤闭塞和愈合机制的病理生物学缺乏证据。需要揭开血管内治疗后动脉瘤愈合之谜，以了解血管内装置与动脉瘤的生物学相互作用，从而指导旨在更好地闭塞动脉瘤的血管内装置的未来发展。我们进行了全面而详细的文献回顾，以了解颅内动脉瘤愈合的病理生物学的所有已知事实，这些知识对神经外科医生、介入神经放射学家、分子生物学家、遗传学家以及动物研究专家至关重要。这篇综述是已知内容的基准，并为与颅内动脉瘤相关的基础科学研究提供了未来研究的平台。
