胶原弹簧圈栓塞兔颅内动脉瘤的实验研究

Experimental study of intracranial aneurysm embolization in rabbit aneurysm models by collagen-based coil

目的研究胶原弹簧圈及铂金弹簧圈对兔动脉瘤模型的栓塞效果及组织反应。方法建立20只新西兰大白兔弹性蛋白酶诱导动脉瘤模型,随机分成两组,分别用胶原弹簧圈(胶原组,n=10)、铂金弹簧圈(铂金组,n=10)进行栓塞。栓塞后2周、10周进行DSA随访,并分别处死5只动物,行组织学分析。结果铂金组模型均为致密栓塞,随访10周仅1例出现血栓形成,且发生动脉瘤复发1例。胶原组均未获致密栓塞,但栓塞2周后,动物均出现明显的弹簧圈周围细胞反应;栓塞10周时,均出现致密结缔组织基质沉积,动脉瘤达到100%栓塞9例,残留瘤颈1例。结论胶原弹簧圈栓塞后可出现明显的细胞反应,并出现进行性血栓形成及致密结缔组织基质沉积;铂金弹簧圈栓塞组动物模型仅出现松散的结缔组织基质沉积,而进行性血栓形成少见。

Objective To investigate the embolization effects and cellular responses to collagen-based coils and platinum coils in rabbit intracranial aneurysm models. Methods Elastase-induced intracranial aneurysm models were established in 20 New Zealand white rabbits. The rabbits were randomly divided into two groups： embolization by collagen-based coils （collagen group, n = 10） and embolization by platinum coils （platinum group, n = 10）. Angiography was performed immediately, 2 weeks and 10 weeks after embolization. Five rabbits of each group were sacrificed in 2 and 10 weeks right after the DSA procedures respectively, and histological analysis was done. Results Complete embolization was achieved in all the aneurysms in the platinum group, and progressive thrombosis was observed only in 1 rabbit and aneurysm recurred in 1 rabbit during a follow-up of 10 weeks. However, incomplete embolization was observed in all the aneurysms in the collagen group, and cellular responses were observed around the coils in all the rabbits after 2 weeks and deposition of dense connective tissue matrix was formed after 10 weeks with 100% embolization was achived in 9 rabbits and neck residue in 1. Conclusion Collagenbased coils can cause marked cellular response, progressive thrombosis and dense connective tissue matrix deposition in rabbit aneurysms, but platinum coils only have loose connective tissue matrix deposition and low rate of progressive thrombosis.