可吸收血流导向支架对兔动脉瘤及正常分支的长期作用  

The long-term effect of biodegradable flow diverting stents on intracranial aneurysms of rabbit model

作　　者：燕鲁滨 卢培刚[1] 王奎重[1] 郝振强[1] 王天助 刘慧 YAN Lubin;LU Peigang;WANG Kuizhong;HAO Zheqiang;WANG Tianzhu;LIU Hui(Department of Neurosurgeu, General Hospital of Jinan MilitaU Command, Jinan 250000, Chin)

机构地区：[1]济南军区总医院神经外科,山东济南250000

出　　处：《中华神经外科疾病研究杂志》2018年第2期100-104,共5页Chinese Journal of Neurosurgical Disease Research

基　　金：国家自然科学基金资助项目(81301020)

摘　　要：目的通过长期随访(≥6个月)两种血流导向支架(FDS)在治疗弹性蛋白酶诱导的兔动脉瘤,探究一种治疗颅内动脉瘤安全、有效的血流导向支架。方法 12只弹性蛋白酶诱导的兔动脉瘤模型被分成实验组和对照组:实验组(n=6),可吸收血流导向支架(BFDS)置入兔载瘤动脉并覆盖动脉瘤颈部,同时在腹主动脉内置入BFDS并覆盖腰动脉开口;对照组(n=6),使用裸金属支架(MFDS)代替BFDS。两组动物分别在支架置入后6个月、12个月行数字减影血管造影(DSA)检查,观察动脉瘤闭塞情况及腹主动脉分支腰动脉是否通畅。所有动物在DSA后取标本行病理学及扫描电镜检查。结果在长期随访中,DSA结果显示:实验组兔动脉瘤完全闭塞率高于对照组,实验组(除了死亡的1只)动脉瘤的完全闭塞率是100%(6/6),对照组动脉瘤的完全闭塞率是20%(1/5)。且两组载瘤动脉DSA显示均通畅。BFDS对于正常血管分支的影响,虽然在扫描电镜和病理结果显示部分新生内膜的增生,但这些变化并未影响腰动脉血流的灌注。结论在长期随访(≥6个月)后,BFDS可有效引起动脉瘤闭塞且对载瘤动脉及正常分支动脉无明显影响。Objective The effect of two flow-diverting stents on the elastase-induced aneurysm of New Zealand rabbit models was followed up for a long term（ 6 months） to investigate the safety and efficiency of stents for the treatment of intracranial aneurysms. Methods Twelve New Zealand white rabbits with elastase-induced aneurysm were divided into the experimental and control groups with six in each. The rabbits in experimental group were implanted the biodegradable flow diverting stents（BFDS） across the necks of aneurysms and the abdominal aortas（AA） covering the ostium of a lumbar artery. The rabbits in control group were used the metal flow diverting stents（MFDS） instead. Both two groups were performed the digital subtraction angiography（DSA）at 6 months and 12 months after FDS implantation to evaluate the status of aneurysm embolization and the patency of side branches covered by FDS. Additionally,all rabbits were sacrificed by intravenous injection of excess sodium pentobarbital for pathology and the scan electron microscope（SEM）. Results In the long-term follow-up,the complete aneurysm occlusion rates were better in the experimental group（100%,6/6） compared to the control group（20%,1/5） in virtue of DSA. SEM and the pathological results revealed neointima hyperplasia around the lumbar artery ostia,but it did not affect the blood flow into the lumbar artery. Conclusion The BFDS is effective for the treatment of aneurysms and is safe for normal perforating arteries covered in the long-term follow-up.

关 键 词：可吸收血流导向支架 金属血流导向支架 动脉瘤 分支动脉 兔 数字减影血管造影 

分 类 号：R608[医药卫生—外科学]