Muto Massimo, Leone Giuseppe, Giordano Flavio, Guarnieri Gianluigi, Di Donna Antonio, Andreone Vincenzo, Di Maro Eva, Poli Alessandro, Fonti Niccolò, Caranci Ferdinando, Muto Mario
"Dipartimento delle Tecnologie Avanzate Diagnostico-Terapeutiche e dei Servizi Sanitari"-UOC Neuroradiologia, Azienda Ospedaliera di Rilievo Nazionale "Antonio Cardarelli", 80131 Napoli, Italy.
"Dipartimento di Emergenza e Accettazione"-UOC Neurologia e Stroke Unit, Azienda Ospedaliera di Rilievo Nazionale "Antonio Cardarelli", 80131 Napoli, Italy.
J Clin Med. 2024 Nov 28;13(23):7222. doi: 10.3390/jcm13237222.
This study aims to investigate the degree of penetration, permanence of occlusion, and vascular changes induced by a newly modified mixture of n-butyl cyanoacrylate (Glubran 2), ethanol, and Lipidol (GEL) in the endovascular treatment of experimental aneurysms induced in swine. Bilateral pouch aneurysms were created in the wall of the internal carotid artery in eighteen pigs. The sixteen aneurysms were treated with a new mixture of GEL with different component proportions. Angiograms were obtained at the time of treatment and at 1, 4, and 16 weeks after treatment. According to the scheduled experimental design, subjects were sacrificed at the time of treatment and 7, 30, and 90 days after the embolization of experimentally induced aneurysms. The internal carotid artery and aneurysms were removed en bloc and sampled for histopathologic study. The mixture induced complete and stable occlusion without recanalization in all experimentally induced aneurysms throughout the study period. Histopathological studies showed focal angionecrosis and acute inflammatory reactions from 7 dpi, followed by chronic inflammation and vessel wall thickening. The GEL mixture may be useful in future clinical applications for the embolization of arteriovenous malformations, the control of acute bleeding, and the isolation of aneurysms due to its very short polymerization time and minimal adhesion to the microcatheter.
本研究旨在探讨一种新改良的氰基丙烯酸正丁酯（Glubran 2）、乙醇和Lipidol（GEL）混合物在猪实验性动脉瘤血管内治疗中所诱导的渗透程度、闭塞持久性及血管变化。在18头猪的颈内动脉壁上制造双侧囊状动脉瘤。16个动脉瘤用不同成分比例的新GEL混合物进行治疗。在治疗时以及治疗后1周、4周和16周获取血管造影图像。根据预定的实验设计，在治疗时以及实验性诱导动脉瘤栓塞后7天、30天和90天对实验对象实施安乐死。将颈内动脉和动脉瘤整体切除并取样进行组织病理学研究。在整个研究期间，该混合物在所有实验性诱导的动脉瘤中均诱导了完全且稳定的闭塞，无再通现象。组织病理学研究显示，从感染后第7天起出现局灶性血管坏死和急性炎症反应，随后是慢性炎症和血管壁增厚。由于GEL混合物聚合时间极短且对微导管的粘附力极小，它可能在未来临床应用中用于动静脉畸形的栓塞、急性出血的控制以及动脉瘤的隔离。
