Turjman F, Massoud T F, Ji C, Guglielmi G, Viñuela F, Robert J
Endovascular Therapy Service, University of California Los Angeles Medical Center, 90024.
AJNR Am J Neuroradiol. 1994 Jun;15(6):1087-90.
To assess the feasibility of combining stent implantation in the parent artery with endosaccular coil placement for the treatment of experimentally created wide-necked aneurysms.
Wide-necked aneurysms were surgically created on the common carotid artery in 12 swine. A metal stent was endovascularly implanted across each aneurysm neck and its effect documented anigiographically. If the aneurysm remained patent, a microcatheter was introduced into the aneurysm through the stent mesh. Electrically detachable coils were delivered into the aneurysm sac to produce thrombosis.
After stent implantation, one carotid artery thrombosed and two aneurysms spontaneously occluded. In the other 9 cases, coils were deposited through the stent to occlude the aneurysm. Complete aneurysm packing was possible in all 9 cases. The presence of the stent allowed placement of small coils near the aneurysm neck, thus contributing to the safe occlusion of small remnants in the final stages of aneurysm packing.
The combination of stent implantation and coil placement is feasible in the treatment of experimental wide-necked saccular aneurysms. The stent maintains patency of the parent artery while allowing aneurysm occlusion by endosaccular coil placement through the stent's mesh. Occlusion of small aneurysm remnants is possible with no fear of coil hernation or migration into the parent artery. Long-term studies will be necessary before application to treatment of selected intracranial aneurysms.
评估在实验性制造的宽颈动脉瘤治疗中，将支架植入载瘤动脉与囊内弹簧圈置入相结合的可行性。
在12头猪的颈总动脉上通过手术制造宽颈动脉瘤。通过血管内将金属支架植入每个动脉瘤颈部，并通过血管造影记录其效果。如果动脉瘤仍保持通畅，将微导管通过支架网孔引入动脉瘤内。将电解可脱弹簧圈送入动脉瘤腔内以形成血栓。
支架植入后，一条颈动脉血栓形成，两个动脉瘤自发闭塞。在其他9例中，通过支架置入弹簧圈以闭塞动脉瘤。所有9例均成功完全填塞动脉瘤。支架的存在使得能够在动脉瘤颈部附近放置小弹簧圈，从而有助于在动脉瘤填塞的最后阶段安全闭塞小的残余部分。
支架植入与弹簧圈置入相结合在治疗实验性宽颈囊状动脉瘤中是可行的。支架可维持载瘤动脉通畅，同时允许通过支架网孔经囊内弹簧圈置入来闭塞动脉瘤。有可能闭塞小的动脉瘤残余部分，而不用担心弹簧圈疝出或移入载瘤动脉。在应用于治疗特定颅内动脉瘤之前，还需要进行长期研究。
