双Willis覆膜支架在犬颈动脉梭形动脉瘤模型的初步应用

Initial application of dual Willis covered stent in treating carotid fusiform aneurysms in canine models

目的建立梭形动脉瘤模型,用以评价双Willis覆膜支架在该动脉瘤模型中的应用价值。方法采用静脉囊移植方法,在犬颈总动脉建立梭形动脉瘤模型。4周后采用"望远镜"技术植入2枚Willis覆膜支架。支架植入后2周、1个月和3个月行血管造影随访,并在1、3个月时行组织病理学检查。结果成功制作8枚梭形动脉瘤模型,并植入16枚Willis覆膜支架。建立动脉瘤模型和支架植入过程均无并发症。血管造影随访显示,6枚动脉瘤模型完全闭塞,2枚动脉瘤模型有少量内漏。组织病理学检查显示支架植入后的内皮化过程,动脉瘤腔内则充满血栓。结论静脉囊移植方法建立的梭形动脉瘤模型或许可以模拟其临床治疗特点,双Willis覆膜支架植入是犬颈动脉梭形动脉瘤模型的有效治疗方法。

Objective To establish experimental model of fusiform aneurysm in canine, and to evaluate dual Willis covered stent implantation in treating fusiform aneurysms. Methods An external jugular vein graft was sutured with the common carotid artery （CCA） to create the fusifornl aneurysm model. After at least 4 weeks, two Willis covered stents were implanted in a telescopic fashion. Follow-up with angiography was conducted at 2 weeks, one and 3 months after the treatment, and the pathological examination of the grafts was made at one and 3 months. The animals were sacrificed at 1 or 3 months after the treatment, and the stents were collected for pathological examination. Results A total of eight fusiform aneurysms were created in four canines, and 16 covered stents were successfully implanted. Neither technique- related nor device- related complications occurred. The follow- up angiographic findings showed that six fusiform aneurysms were completely occluded and a minimal endoleak occurred in two fusiform aneurysms. Histological examination revealed endothelialization progress, and all aneurysm sacs were filled with thrombi. Conclusion The fusiform aneurysm model created by suturing vein graft with CCA might imitate its clinical features. Dual Willis covered stents implantation is an effective treatment for carotid fusiform aneurysm in canine. （J Intervent Radiol, 2013, 22： 709-713）