Mawad M E, Mawad J K, Cartwright J, Gokaslan Z
Department of Radiology, Baylor College of Medicine, Houston, Tex.
AJNR Am J Neuroradiol. 1995 Jan;16(1):7-13.
To evaluate the long-term histologic changes, including those in the ultrastructure of the neoendothelium, occurring in experimental canine aneurysms obliterated with Guglielmi detachable coils.
Ten experimental aneurysms were surgically created in mongrel dogs using side-to-side jugular carotid fistulas that were subsequently ligated to form blind pouch venous aneurysms dependent on the carotid circulation. The aneurysms were obliterated with Guglielmi detachable coils, and the animals were kept in observation. Six months after the endovascular obliteration of the aneurysms, repeat carotid arteriography was performed to assess for potential recanalization of the aneurysms. The animals were then killed and submitted for autopsy. The carotid artery and the embolized aneurysm were resected and studied with light and electron microscopy.
Both completely obliterated and recanalized aneurysms were excluded from the parent circulation by an endothelialized layer of connective tissue. The fundus of the aneurysm was completely obliterated by heavy reactive fibrous tissue surrounding the coils with very minimal, if any, inflammatory reaction. The neointima is composed of three well-identifiable layers, the most superficial of which is formed of new endothelial cells positioned next to each other in a cobblestone fashion over a basal membrane.
In the absence of histologic data in human aneurysms obliterated with Guglielmi detachable coils, several observations made in our experimental study help in the understanding of the long-term results expected from this endovascular technique.
评估使用 Guglielmi 可脱卸弹簧圈闭塞的实验性犬动脉瘤的长期组织学变化，包括新生内皮超微结构的变化。
在杂种犬身上通过颈总动脉侧侧瘘手术制造 10 个实验性动脉瘤，随后结扎形成依赖颈动脉循环的盲袋静脉性动脉瘤。用 Guglielmi 可脱卸弹簧圈闭塞动脉瘤，并对动物进行观察。在动脉瘤血管内闭塞 6 个月后，进行重复颈动脉血管造影以评估动脉瘤的潜在再通情况。然后处死动物并进行尸检。切除颈动脉和栓塞的动脉瘤，进行光镜和电镜研究。
完全闭塞和再通的动脉瘤均被结缔组织内皮化层与母循环隔离开。动脉瘤底部被围绕弹簧圈的大量反应性纤维组织完全闭塞，炎症反应极少（若有）。新生内膜由三个可明确识别的层组成，最表层由新的内皮细胞组成，这些细胞在基底膜上以鹅卵石样方式彼此相邻排列。
在缺乏使用 Guglielmi 可脱卸弹簧圈闭塞的人类动脉瘤组织学数据的情况下，我们实验研究中的一些观察结果有助于理解这种血管内技术预期的长期效果。
