低孔率血流导向装置治疗兔囊状宽颈动脉瘤及对分支的影响  

Effects of flow diversion stents on rabbits＇ wide necked aneurysms and branches

作　　者：刘建民[1] 王奎重[1] 黄清海[1] 许奕[1] 洪波[1] 方兴根[1] 李振[1] 

机构地区：[1]第二军医大学长海医院神经外科,上海200433

出　　处：《中华神经外科杂志》2010年第11期984-987,共4页Chinese Journal of Neurosurgery

基　　金：国家自然科学基金（30901556）;上海市自然科学基金（08ZR1404200）

摘　　要：目的 观察低孔率血流导向装置对兔囊状动脉瘤的治疗作用和对分支的影响.方法 取30只兔宽颈动脉瘤模型,随机平均分为三组.A、B组动物载瘤动脉内分别植入金属覆盖率30%～35%和45%～50%低孔率血流导向装置,术后4周造影,3个月后再次造影并处死动物行病理检查.C组动物载瘤动脉内不植入支架,分组后和3个月时造影并行病理学检查.结果 A、B两组支架植入后即刻造影显示造影剂滞留率分别是88.7%和100%,4周造影显示动脉瘤闭合率分别是77.8%和85.7%,3个月时动脉瘤闭合率分别是71.4%和85.7%;支架所覆盖的分支血流通畅;动脉瘤颈部和载瘤动脉内薄层新生内膜覆盖支架,瘤腔充满血栓.C组分组后和处死前动脉瘤大小差异无统计学意义（P＞0.05）.结论 单纯植入低孔率血流导向装置是治愈脑动脉瘤的一种可行方法,对分支血流无明显影响.Objective To observe the effects of flow diversion stents on rabbits＇ aneurysms and branches.Method 30 New Zealand white rabbits with wide necked aneurysm were randomly divided equally into three groups.In group A and B,flow diversion stents were implanted into parent vessel with metal coverage 30%～35% and 45%～ 50%,respectively.Angiography was performed at 4 weeks after stent implantation.After 3 months all animals were euthanized for pathological examination after angiography.In group C,animals were only performed for angiography without any stent implanted after grouped and at 3 months,and then animals were euthanized for pathological examination after angiography.Results Immediately after stents placement,90% and 70% aneurysms＇ necks covered by stents successful in group A and B,respectively.The contrast retention in aneurysms were 88.7% and 100%,respectively.intravenous digital subtraction angiography showed that 77.8% and 85.7% aneurysms were completely occluded at 4 weeks fogow -up,respectively.Artery digital subtraction angiography showed that 71.4% and 85.7% aneurysms were occluded at 3 months follow- up,respectively.All branches covered by stents were patency at angiography follow - up.Pathologic analysis showed that the dome of embolized aneurysms was full filled with thrombus and neointimas at neck and parent vessel were found.In group C,mean aneurysm dimensions were not significantly changed in angiography after grouped and before sacrificed at 3 months（ P 〉 0.05）.Conclusions The flow diversion stents are effective in the treatment of wide necked aneurysms with preservation of adjacent branch vessels in angiography.

关 键 词：低孔率血流导向装置 金属覆盖率 颅内动脉瘤 分支血管 兔 

分 类 号：R686[医药卫生—骨科学]