Dawson R C, Krisht A F, Barrow D L, Joseph G J, Shengelaia G G, Bonner G
Emory University School of Medicine, Division of Neuroradiology, Atlanta, Georgia.
Neurosurgery. 1995 Jan;36(1):133-9; discussion 139-40. doi: 10.1227/00006123-199501000-00017.
Endovascular treatment of certain surgically difficult aneurysms is currently performed using fibered microcoils or electrolytically detachable microcoils to obliterate these lesions by forming an intra-aneurysmal thrombus. Unfortunately, this treatment option results in a significant incidence of incomplete obliteration of treated aneurysms. A thrombus can recanalize, resulting in further aneurysm growth and subsequent rupture. Nineteen aneurysms were surgically created in 10 pigs using jugular venous pouches. The aneurysms were allowed to mature for periods of 7 days to as long as 11 weeks prior to embolization. Fourteen remained patent for embolization. The aneurysms were then embolized (9 with collagen-coated microcoils, 5 with dacron-fibered platinum microcoils). Follow-up angiograms were obtained prior to sacrifice at 1, 3, 6, 9, and 12 weeks postembolization, and the embolized aneurysms and parent vessels were harvested for histopathological studies. The current study was designed to evaluate the potential efficacy of collagen-coated microcoils in providing an enduring therapy for aneurysms by comparing this new embolic device with the standard dacron-fibered platinum microcoils in a swine common carotid artery side wall aneurysm model. The aneurysms treated with collagen microcoils were completely obliterated with a collagen-rich fibrous scar with no histological evidence of residual thrombus or recanalization. Additionally, after treatment of experimental aneurysms with collagen microcoils, re-endothelialization across the former aneurysm neck was seen. In contrast, aneurysms embolized with dacron-fibered microcoils contained persistent thrombus surrounded by a relatively immature scar with residual aneurysmal lumen and lack of endothelium.(ABSTRACT TRUNCATED AT 250 WORDS)
目前，对于某些手术治疗困难的动脉瘤，采用纤维微线圈或电解可脱微线圈进行血管内治疗，通过形成瘤内血栓来闭塞这些病变。不幸的是，这种治疗方法导致治疗的动脉瘤不完全闭塞的发生率很高。血栓可再通，导致动脉瘤进一步生长并随后破裂。在10头猪身上利用颈静脉球囊手术制造了19个动脉瘤。在栓塞前，使动脉瘤成熟7天至长达11周。14个动脉瘤保持通畅以便进行栓塞。然后对动脉瘤进行栓塞（9个用胶原涂层微线圈，5个用涤纶纤维铂微线圈）。在栓塞后1、3、6、9和12周处死前获得随访血管造影，并且采集栓塞的动脉瘤和供血血管进行组织病理学研究。本研究旨在通过在猪颈总动脉侧壁动脉瘤模型中，将这种新型栓塞装置与标准的涤纶纤维铂微线圈进行比较，评估胶原涂层微线圈为动脉瘤提供持久治疗的潜在疗效。用胶原微线圈治疗的动脉瘤被富含胶原的纤维瘢痕完全闭塞，没有残留血栓或再通的组织学证据。此外，在用胶原微线圈治疗实验性动脉瘤后，可见原动脉瘤颈部重新内皮化。相比之下，用涤纶纤维微线圈栓塞的动脉瘤含有持续血栓，周围是相对不成熟的瘢痕，有残留的动脉瘤腔且缺乏内皮。（摘要截短于250字）
