支架与弹簧圈联合治疗实验性宽颈颈动脉动脉瘤：初步结果
Combined use of stents and coils to treat experimental wide-necked carotid aneurysms: preliminary results.
作者信息
Szikora I, Guterman L R, Wells K M, Hopkins L N
机构信息
Dent Neurologic Institute, Buffalo, NY.
出版信息
AJNR Am J Neuroradiol. 1994 Jun;15(6):1091-102.
PURPOSE
To develop a new technique to treat wide-necked side-wall aneurysms, combining the implantation of intraarterial stents with the endosaccular placement of coils.
METHODS
Bilateral side-wall aneurysms were surgically created on the carotid arteries of four dogs. In each animal, Guglielmi detachable coils were introduced into one of the aneurysms after implantation of a balloon-expandable Strecker stent within the parent artery, adjacent to the aneurysm orifice. The contralateral aneurysms were treated with coils alone.
RESULTS
In two dogs, one of the stented and both nonstented aneurysms remained partially open for 4 weeks after subtotal packing with coils. In another two dogs, tight aneurysm packing with coils resulted in complete occlusion of all four aneurysms. Bulging of the coil mass resulted in 30% to 75% narrowing of the nonstented parent arteries. At 4 and 5 weeks, significant stenosis resulting from reactive hyperplasia was observed in all stented carotid arteries.
CONCLUSION
Based on these preliminary results, we conclude that Guglielmi detachable coils can be introduced into an aneurysm cavity through Strecker stents. The stents allow tighter packing of wide-necked aneurysms by preventing coils from migrating or bulging into the parent arteries.
目的
开发一种治疗宽颈侧壁动脉瘤的新技术，将动脉内支架植入与瘤腔内弹簧圈置入相结合。
方法
在4只犬的颈动脉上手术制造双侧侧壁动脉瘤。在每只动物中，在动脉瘤口附近的载瘤动脉内植入球囊扩张式施特雷克支架后，将 Guglielmi 可脱卸弹簧圈引入其中一个动脉瘤。对侧动脉瘤单纯用弹簧圈治疗。
结果
在2只犬中，用弹簧圈部分填塞后，1个植入支架的动脉瘤和2个未植入支架的动脉瘤在4周内仍部分开放。在另外2只犬中，用弹簧圈紧密填塞动脉瘤导致所有4个动脉瘤完全闭塞。弹簧圈团块膨出导致未植入支架的载瘤动脉狭窄30%至75%。在4周和5周时，在所有植入支架的颈动脉中均观察到反应性增生导致的明显狭窄。
结论
基于这些初步结果，我们得出结论，Guglielmi可脱卸弹簧圈可通过施特雷克支架引入动脉瘤腔。支架通过防止弹簧圈移入或膨入载瘤动脉，使宽颈动脉瘤能够更紧密地填塞。
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