Deveikis J P, Manz H J, Luessenhop A J, Caputy A J, Kobrine A I, Schellinger D, Patronas N
Department of Radiology (Neuroradiology) Georgetown University Hospital, Washington, DC.
AJNR Am J Neuroradiol. 1994 Feb;15(2):263-71.
To evaluate the safety and efficacy of silk suture as an agent for preoperative embolization of cerebral arteriovenous malformations.
Clinical and histopathologic results were analyzed in six patients who underwent embolization of cerebral arteriovenous malformations using silk suture in combination with other agents.
Three of the patients treated with silk hemorrhaged after embolization, and two of these patients died. Neuropathologic analysis of four patients showed acute perivascular inflammation, sometimes quite severe.
The inflammatory response to silk may explain its effectiveness in producing vascular occlusion. However, a fulminate vasculitis theoretically can predispose to delayed hemorrhage. Other problems with silk include the pressure required to inject the agent and the inability to determine the final site of deposition of the silk. Although other embolic agents may share some of these potential difficulties, we feel that the disadvantages outweigh the advantages of silk as an embolic agent.
评估丝线作为脑动静脉畸形术前栓塞剂的安全性和有效性。
对6例使用丝线联合其他药物进行脑动静脉畸形栓塞的患者的临床和组织病理学结果进行分析。
3例接受丝线治疗的患者在栓塞后出血，其中2例死亡。对4例患者的神经病理学分析显示有急性血管周围炎症，有时相当严重。
对丝线的炎症反应可能解释了其产生血管闭塞的有效性。然而，暴发性血管炎理论上可能易导致延迟性出血。丝线的其他问题包括注射药物所需的压力以及无法确定丝线的最终沉积部位。尽管其他栓塞剂可能也存在一些潜在困难，但我们认为丝线作为栓塞剂的缺点超过了优点。
