Kwan E S, Heilman C B, Roth P A
Department of Radiology, New England Medical Center Hospitals, Boston, MA 02111.
AJNR Am J Neuroradiol. 1993 Mar-Apr;14(2):323-33.
To assess the value of endovascular packing of intracranial bifurcation aneurysms with commercially available coils.
Carotid bifurcation aneurysms were surgically created in 12 New Zealand rabbits with subsequent assessment of the extent of aneurysm ablation following endovascular packing with polyester fiber-coated platinum coils.
Follow-up angiograms obtained from 29 to 108 days postprocedures showed various degrees of aneurysm ablation. Complete obliteration of aneurysm dome occurred in seven out of eight rabbits, while ablation of aneurysm neck was successful in only one out of eight. No spontaneous thrombosis was observed in seven control animals over a 3-month period. Coils of various configurations used in this experiment all maintained stable intraaneurysmal position. Histologic examination of treated aneurysms consistently demonstrated extensive proliferation of spindle cells on the coil surface and in interstices between coils with channels lined by cells resembling endothelial cells. Organized thrombus was not a prominent feature.
Endovascular packing of human bifurcation aneurysms with current commercially available polyester fiber-coated platinum coils may not result in complete obliteration of the aneurysm with reendothelialization occurring across the aneurysm neck.
评估使用市售线圈进行颅内分叉动脉瘤血管内栓塞的价值。
在12只新西兰兔身上手术制造颈动脉分叉动脉瘤，随后用聚酯纤维涂层铂线圈进行血管内栓塞，评估动脉瘤消融程度。
术后29至108天的随访血管造影显示出不同程度的动脉瘤消融。八只兔子中有七只动脉瘤穹窿完全闭塞，而八只中只有一只动脉瘤颈部消融成功。七只对照动物在三个月内未观察到自发血栓形成。本实验中使用的各种构型的线圈在动脉瘤内均保持稳定位置。对治疗后的动脉瘤进行组织学检查，始终显示线圈表面和线圈间隙中有大量梭形细胞增殖，间隙中有类似内皮细胞衬里的通道。有组织的血栓不是突出特征。
使用目前市售的聚酯纤维涂层铂线圈对人类分叉动脉瘤进行血管内栓塞，可能无法使动脉瘤完全闭塞，且动脉瘤颈部会发生再内皮化。
