犬末端型颈动脉瘤微弹簧圈栓塞的实验研究

Experimental studies on canine terminal carotid arterial aneurysm models pre-and post-embolized with microcoil

目的 建立犬颈总动脉 (CCA)末端型囊状动脉瘤 (AN)模型 ,评价微弹簧圈行动脉瘤腔栓塞前后影像学、血流动力学的改变。方法 运用改进的显微外科技术制作 7个CCA末端型动脉瘤 ,术后7～ 14d行彩色多普勒超声仪、磁共振成像 (MRI)、磁共振血管成像 (MRA)、数字减影动脉血管造影(IADSA)检查 ,进行动脉瘤模型的计算机流体力学 (CFD)模拟分析。以微弹簧圈 (MC)紧密填塞动脉瘤并再次进行上述检查和病理分析。结果 所有模型均获得成功 ,MC瘤腔栓塞能取得良好效果。DSA结合无创影像学可以提高对动脉瘤的诊断和全面认识 ,血流动力学分析能模仿出犬颈部动脉瘤的血流动力学变化。结论 该模型是进行AN血管内栓塞治疗研究的理想模型 ;非DSA的影像设备检查对AN的栓塞前后的评价具有无创、可重复、显示清楚的特点 ;CFD研究显示 ,对于动脉瘤血流流入道的治疗干预 。

Objective To establish canine terminal saccular aneurysm model of common carotid artery(CCA), and evaluate the images and hemodynamic changes of aneurysm cavities pre- and post-embolized with microcoil (MC). Methods Seven CCA terminal saccular aneurysm models had been created by using improved microsurgical technique. Seven to fourteen days after surgery, models were undergone color Doppler, Magnetic resonance image (MRI), Magnetic resonance angiography (MRA), digital subtraction angiography (DSA), and then the analysis of computational fluid dynamics (CFD) on these animal models were conducted. Afterwards they were compactly packed with MC, and then aneurysms again were examed under these methods, and simultion of pathological changes. Results Models were created successfully with good MC compactly pack aneurysm cavities. DSA combined with other imaging methods can improve the diagnosis of aneurysms completely. CFD models can show the imitation hemodynamics of canine carotid aneurysms. Conclusions This kind of aneurysm model is an ideal one on the area for the research of aneurysm embolization. Non-DSA imaging examination can noninvasively, repeatedly, clearly evaluate aneurysms pre-and post-embolized with MC. The interference on the inflow zone of the aneurysm is an effective method for cure and preventing recurrence of aneurysms.