犬脑血管痉挛经皮腔内血管成形术治疗

Percutaneous transluminal angioplasty for treatment of experimental cerebral vasospasm

目的 探讨经皮腔内血管成形术 (PTA)治疗顽固性脑血管痉挛的可行性和效果。方法 成年杂种犬 2 0只 ,采用枕大池两次注血模型。应用扩张后直径为 1.5mm的硅胶球囊 ,扩张压力为 2个大气压、持续时间 10s,在痉挛的基底动脉近、远端分别扩张 1次。结果 2 0只犬的基底动脉均发生痉挛 ,为其中的 14只进行了PTA治疗 ,成功13只、死亡 1只 ;另外的 6只犬 ,由于血管解剖原因 ,无法进行PTA操作。PTA治疗后 ,痉挛的基底动脉明显扩张 ,犬神经功能恢复明显加快。 2 0d后复查脑血管造影 ,接受PTA治疗犬的基底动脉显影基本正常 ,而未进行PTA治疗犬的基底动脉仍有明显的痉挛。

Absract:Objective To study the effects of treatment on experimental cerebral vasospasm with percutaneous transluminal angioplasty(PTA).Methods Twenty adult mongrel dogs of both sexes served as the subject.Subarachniod hemorrhage(SAH) was induced by injecting autologous blood into the brain cisterns.A silicon balloon with its diameter 1.5 mm was positioned into the proximal and distal basilar artery in turn.PTA was performed by a single inflation of balloon for 10 seconds at a pressure of 2.0 ATA.Results Basilar arteries of all the dogs were constricted after SAH.PTA was performed only in 14 of them,13 ones successed and 1 died.The other 6 dogs failed to received PTA for their vertebral arteries turning too sharply to allow the balloon to pass through at the level of second vertebra.After PTA the constricted arteries were dilated significantly and also remained a nice condition when re examination did 20 days later,but the untreated animals with the vasospastic arteries showed little change at the same time.Neurologic function grade evaluation showed that dogs received PTA healed more quickly.Conclusions PTA was effective for treatment of cerebral vasospasm.