Sharafuddin M J, Gu X, Cervera-Ceballos J J, Urness M, Amplatz K
Department of Radiology, University of Minnesota Hospital and Clinic, Minneapolis 55455, USA.
J Vasc Interv Radiol. 1996 Sep-Oct;7(5):695-703. doi: 10.1016/s1051-0443(96)70831-x.
To evaluate the efficacy and recanalization rates of a newly designed vascular occlusion device.
The self-expanding vascular occluder was braided from fine nitinol wires and filled with polyester fibers. The device was delivered through a 6-F polyethylene introducing sheath with use of a delivery cable with a microscrew adaptor. Comparison was made between one occlusion plug and two Gianturco coils placed in the corresponding contralateral arterial segment in nine dogs and six pigs. The mean diameter of the targeted vessels was 4.8 mm +/- 0.8. Two animals were killed immediately after occlusion, and the remaining 13 animals underwent follow-up angiography at 1 week and/or 1 month, after which the animals were killed and the vessels were explanted for gross and histopathologic examination.
Significantly shorter time-to-occlusion was achieved with the nitinol plug compared with two Gianturco coils (1.73 minutes +/- 1.28 vs 5.73 minutes +/- 6.18; P = .021). The recanalization rate at 1 month was also significantly lower (36.4% vs 81.8%, P = .027). The occlusion time was strongly dependent on the target artery diameter with Gianturco coils (R = .79, P = .0007), and not with the nitinol plug.
The nitinol vascular occluder appears highly effective and reliable, with one plug resulting in significantly faster and longer lasting occlusions compared with two Gianturco coils. The new device can be repositioned prior to release, therefore allowing optimal positioning.
评估一种新设计的血管闭塞装置的疗效和再通率。
自膨胀式血管封堵器由细镍钛诺丝编织而成，并填充聚酯纤维。该装置通过带有微螺丝适配器的输送电缆，经6F聚乙烯导入鞘管输送。将9只犬和6只猪相应对侧动脉段置入一个封堵栓与两个Gianturco弹簧圈的情况进行比较。目标血管的平均直径为4.8mm±0.8。两只动物在闭塞后立即处死，其余13只动物在1周和/或1个月后接受随访血管造影，之后处死动物并取出血管进行大体和组织病理学检查。
与两个Gianturco弹簧圈相比，镍钛诺封堵栓实现闭塞的时间明显更短（1.73分钟±1.28 vs 5.73分钟±6.18；P = 0.021）。1个月时的再通率也显著更低（36.4% vs 81.8%，P = 0.027）。Gianturco弹簧圈的闭塞时间强烈依赖于目标动脉直径（R = 0.79，P = 0.0007），而镍钛诺封堵栓则不然。
镍钛诺血管封堵器似乎高效且可靠，与两个Gianturco弹簧圈相比，一个封堵栓导致闭塞明显更快且持续时间更长。这种新装置在释放前可重新定位，因此能实现最佳定位。
