Geremia G, Bakon M, Brennecke L, Haklin M
Department of Diagnostic Radiology, Rush-Presbyterian-St Luke's Medical Center, Chicago, Ill 60612, USA.
AJNR Am J Neuroradiol. 1995 Nov-Dec;16(10):1965-73.
To determine the efficacy of porous metallic stents in the treatment of experimentally created carotid-jugular fistulas.
Carotid-jugular fistulas were constructed surgically in five mongrel dogs. Porous metallic stents were placed endovascularly across the fistula holes within the carotid artery; carotid angiography was performed before, immediately after, and 1 and 2 months after stent placement. The fistula specimens were resected 2 months after stent placement; gross and light microscopic analyses were performed.
Angiography revealed complete closure of three of the five fistulas 1 month after stent placement; two of the five fistulas remained patent but demonstrated diminished flow rate. All carotid arteries were widely patent throughout the study. Gross pathology of the carotid-jugular specimens revealed fibrous connective tissue and collagen within the fistula hole. A thin layer of endothelium covered the stent wires and the fibrous connective tissue overlying the fistula hole.
The stents were effective in closing three of the five fistulas and reducing flow through the fistulas in the remaining animals. With further refinements and variations in technique, porous metallic stents may prove a viable alternative to current endovascular devices for treatment of certain arteriovenous fistulas.
确定多孔金属支架治疗实验性建立的颈静脉瘘的疗效。
对5只杂种犬手术建立颈静脉瘘。将多孔金属支架经血管内放置于颈动脉内的瘘口处；在支架置入前、置入后即刻、置入后1个月和2个月进行颈动脉血管造影。在支架置入2个月后切除瘘标本；进行大体和光学显微镜分析。
血管造影显示，5个瘘口中有3个在支架置入1个月后完全闭合；5个瘘口中有2个仍保持通畅，但血流速度降低。在整个研究过程中，所有颈动脉均广泛通畅。颈静脉标本的大体病理显示瘘口内有纤维结缔组织和胶原。一层薄薄的内皮覆盖在支架丝和瘘口上方的纤维结缔组织上。
支架可有效闭合5个瘘口中的3个，并减少其余动物瘘口的血流。随着技术的进一步改进和变化，多孔金属支架可能被证明是治疗某些动静脉瘘的现有血管内装置的可行替代方案。
