Nazarian G K, Qian Z, Vlodaver Z, Pozza C H, Castañeda-Zúñiga W R, Hunter D W, Amplatz K
Department of Radiology, University of Minnesota Hospital and Clinic, Minneapolis 55455-0392.
Invest Radiol. 1993 Dec;28(12):1165-9. doi: 10.1097/00004424-199312000-00017.
A new vascular occlusion device was tested in canine femoral and iliac arteries and in an animal model of a patent ductus arteriosus (PDA).
Four variations of the vascular plug were placed into 18 iliac or femoral arteries of 17 mongrel dogs. Follow-up angiography was performed 1 hour and, if necessary, 2 hours after placement in all animals, 14 of which were then killed. Three dogs were followed angiographically for 2 weeks to 3 months. The "butterfly" plug was then tested in a canine model of a PDA.
All plugs contained thrombi, and 12 of the 18 devices caused complete or nearly complete vascular occlusion within 2 hours. In one dog, one vascular plug had eroded through the vessel wall at 3 months without clinical sequelae. Successful PDA occlusion was achieved in 1 or 2 days in 6 of 8 dogs. Three misplacements occurred, one of which resulted in death.
The balloon-expandable vascular plug appears to be a promising device for occlusion of blood vessels. Migration has not been observed once the device is placed, thus, sizing of the device appears less critical than with coils. However, modification of the delivery system and considerably more experience with the device are necessary to reduce the risk of misplacement.
一种新型血管闭塞装置在犬股动脉和髂动脉以及动脉导管未闭(PDA)动物模型中进行了测试。
将该血管封堵器的四种变体植入17只杂种犬的18条髂动脉或股动脉中。所有动物在植入后1小时进行随访血管造影,必要时在2小时后进行;其中14只动物随后被处死。对3只犬进行了2周至3个月的血管造影随访。然后在PDA犬模型中测试“蝴蝶”封堵器。
所有封堵器均形成血栓,18个装置中有12个在2小时内导致完全或几乎完全血管闭塞。在1只犬中,1个血管封堵器在3个月时穿透血管壁,但无临床后遗症。8只犬中有6只在1至2天内成功实现PDA闭塞。发生了3次误置,其中1次导致死亡。
球囊可扩张血管封堵器似乎是一种有前景的血管闭塞装置。装置放置后未观察到移位,因此,与线圈相比,装置尺寸的要求似乎不那么严格。然而,为降低误置风险,需要对输送系统进行改进,并积累更多使用该装置的经验。