国产镍钛合金血管内裸支架治疗囊形腹主动脉瘤的实验研究

The experimental study of treating the cystiform abdominal aneurysms by homemade TiNi shape memory mesh endovascular stents

目的 研究、观察国产血管内支架治疗犬腹主动脉瘤的疗效。方法 采用简单随机分组方法 ,将健康杂种犬 32只随机分为 4组 ,每组 8只。组 1:对照组 ,未置入支架 ;组 2 :实验组 ,腹主动脉前壁纵行切口长度≤ 1cm ,置入支架治疗 ;组 3 :实验组 ,腹主动脉前壁纵行切口长度 >1cm且≤ 2cm ,置入支架治疗 ;组 4:实验组 ,腹主动脉前壁纵行切口长度≥ 3cm ,置入支架治疗。外科方法建立腹主动脉瘤模型后 2周行介入治疗。术后每个月行增强CT检查 ;第 6个月处死时 ,行腹主动脉造影检查。结果 组 1在 6个月观察期内 ,CT和腹主动脉造影检查均示瘤腔存在。组 2于第 1个月CT检查时发现有 1只犬瘤腔闭合 ;第 2个月CT检查时有 4只犬瘤腔闭合 ;第 3个月有 2只犬瘤腔闭合 ;第 4个月有 1只犬瘤腔闭合 ;第 6个月腹主动脉造影检查也证实瘤腔闭合。组 3CT检查和腹主动脉造影检查发现每只犬均残留有 1个小瘤腔 ,且瘤壁呈向心性增厚。组 4CT检查和腹主动脉造影检查发现每只犬均显示有 1个大瘤腔。 32只犬的腹主动脉均通畅。结论 国产镍钛合金血管内裸支架 ,对瘤颈直径≤ 1cm的腹主动脉瘤有治疗作用 ;对瘤颈直径 >1cm且≤ 2cm者 ,可防止动脉瘤继续扩张和迟发破裂 ;对瘤颈直径≥ 3cm者则无任何治疗作用。

Objective To develop the homemade TiNi shape memory mesh endovascular stent and to observe its therapeutic effect on the abdominal aneurysm. Methods Thirty two healthy mongrel dogs were randomly divided into 4 groups according to the designed standard. There were 8 dogs in each group. The models of abdominal aneurysm were created by surgery. The stents were implanted to treat the aneurysms after 14 days. All dogs were underwent monthly CT scanning until 6 months. All of them were sacrificed after abdominal aortography. Results Within 6 months, CT scanning and abdominal aortography showed that the sacs were persistently present in Group Ⅰ(control). Through CT scanning and abdominal aortography, the aneurysmal sacs were occluded in the 1st, 2nd, 3rd, and 4th month in group Ⅱ, respectively. A small sac (less then 1 cm in diameter) was seen in all dogs in group Ⅲ. The walls of the small sacs were concentrically thickened. A large sac was seen in all dogs in group Ⅳ. The abdominal artery was unobstructed in all animals. Conclusion The homemade TiNi shape memory mesh endovascular stent with the pore size of 4.3 mm 2 appears to be a suitable device to instantly exclude the abdominal aneurysms (aneurismal diameter≤1 cm). The same stent appears to has the possibility in preventing the expansion and postponed rupture of aneurysms (aneurismal diameter >1 cm but ≤2 cm). It didn't have any effect on larger aneurysms (aneurismal diameter ≥3 cm).