动脉瘤模型栓塞前后血流动力学对比研究

Matched control of hemodynamics in pre-and post-embolized aneurysm models with microcoils

目的 评价动脉瘤模型行腔内微弹簧圈栓塞前后血流动力学的改变，用以判断疗效。方法 运用改进的显微外科技术建立犬颈总动脉（CCA）动脉瘤模型22个，其中侧壁型12个，分叉部4个，末端型6个。术后7～14d行彩色多普勒超声、经颅多普勒（TCD）、数字减影动脉血管造影（IADSA）及经微导管动脉瘤内测压，然后以微弹簧圈紧密填塞动脉瘤腔，栓塞后重复进行上述检查，比较栓塞前后血流动力学变化。结果 所建模型均获成功。实验证实，动脉瘤微弹簧圈栓塞前后其血流动力学参数的差异有统计学意义（P〈0．01）。结论 实验所建动物模型是研究动脉瘤血管内栓塞治疗的理想方法；动脉瘤微弹簧圈栓塞后，能减低、改变或消除载瘤动脉及动脉瘤内异常血流动力学状态，终止动脉瘤行为，防止动脉瘤扩大和破裂。

Objective To evaluate the alteration of hemodynarnics in pre- and post-embolized aneurysm models with microcoils, and to judge the therapeutic effectiveness of embolization. Methods Three types of canine common carotid artery aneurysms were established by using microsurgical techniques, including lateral type in 12 cases, bifurcation type in 4 cases and terminal type in 6 cases. Seven-14 clays after surgery, the hemodynamic information of these models was obtained with color Doppler, TCD, IADSA and measurement of the pressure in aneurysms by micro-guide. The aneurysms were treated with compactly packed microcoils. The hemodynamic information of the pre- and post- embolized aneurysms was compared and their pathological changes were observed. Results All types of aneurysms models were created successfully. There was significant difference in hemodynamics parameter between pre- and post- embolized aneurysms with microcoils. Conclusion Animal models of intracranial aneurysms established in our experiments were ideal for the investigation of endovascular therapeutic strategy. Embolization of the aneurysms with microcoils can letdown or remove the abnormral hemodynamics state of the origin arteries and the aneurysms, stop the aneurysm behavior and to prevent the expand and the break of the aneurysms.