Electrolytic detachable coils (EDC) have been the main embolic materi als for intracranial aneurysms. Liquid aneurysmal embolic materials represented by cellulose acetate polymer (CAP) are still in controversy. In thi...Electrolytic detachable coils (EDC) have been the main embolic materi als for intracranial aneurysms. Liquid aneurysmal embolic materials represented by cellulose acetate polymer (CAP) are still in controversy. In this research, t he embolization results and pathological reactions after embolization of canine aneurysmal models with EDC or CAP were observed and compared. Methods. The canine aneurysmal models constructed by anastomosis of venous pouch es were randomly grouped. The aneurysms were respectively occluded with CAP and electrolytic detachable coils that was named by Wu electrolytic detachable coil (WEDC) and made by us. Angiogram follow ups were performed at 24 hour, 2 week , and 2 month after embolization. The occluded aneurysms were dissected in each stage for light microscopic, electron microscopic, and histochemical research. Results. The effect of embolization was significantly better with WEDC than that with CAP . Post embolized complications such as aneurysm rupture and stenosis of parent arteries could only be found in CAP group. Pathol ogical research showed that CAP mass could packed the aneurysms more densely tha n coils. Acute chemical damage of aneurysmal wall and inflammatory cell infiltra tion was prominently found in early stage after CAP embolization. Organization of thrombus inside aneurysms and formation of endothelial tissue over the orific es of aneurysmal necks could be found in both groups 2 months after embolization . But parts of coils might be exposed outside endothelial layer. Conclusions. EDC are still the most safe, efficient, and reliable instruments to embolize aneurysm. CAP should be improved further to solve the problem of stron g chemical corrosion and difficulty in control before it is widely used.展开更多
Objective. To compare the embolization effects of intracranial aneurysms with mechanical detachable spirals (MDS) and with Guglielmi detachable coils (GDC).Methods. One hundred and twenty cases with 125 intracranial a...Objective. To compare the embolization effects of intracranial aneurysms with mechanical detachable spirals (MDS) and with Guglielmi detachable coils (GDC).Methods. One hundred and twenty cases with 125 intracranial aneurysms were embolized in Beijing Hospital from March 1995 to July 1999. Sixty - six aneurysms in 64 cases were embolized with MDS, 51 in 48 with GDC, and 8 in 8 with both MDS and GDC. Clinical data including sex, age, subarachnoid hemorrhage (SAH), Hunt & Hess grading, diameter and neck width of aneurysms, number and length of coils used per aneurysm, occlusive ratio, and complications were compared between MDS and GDC groups.Results. MDS and GDC groups were comparable (t-test or x2 -test, all P value > 0. 10) in terms of age, sex, diameter of aneurysms [ (8. 46 ± 3. 42) mm vs. (7. 38 ± 3. 45) mm], neck width [ (3. 49 ± 1. 50) mm vs. (3. 26 ± 1. 52) mm], coils number[ (4. 65 ± 3. 01) vs. (4. 24 ± 2. 65) ] and their length[ (460. 2 ± 398. 5) mm vs. (422. 9 ±387. 1) mm] used per aneurysm, occlusive ratio in aneurysms embolized ≥80% [ (95. 00% ± 6. 32% ) vs. (94. 19% ± 7. 63% ) ], mortality and permanent complications (7. 8% vs. 4. 2% ).Conclusions. MDS and GDC are all materials for embolization of intracranial aneurysms. MDS is less expensive, but more difficult to control and of propensity to complications while GDC is more compliant, easier to be used, safer, and have many alternative types for use as well as more extensive indications.展开更多
Background Treatment of cavernous dural arteriovenous fistulas （DAVF） is usually made by a transarterial approach. However, in many complicated patients, treatments via transarterial approaches can not be achieved, ...Background Treatment of cavernous dural arteriovenous fistulas （DAVF） is usually made by a transarterial approach. However, in many complicated patients, treatments via transarterial approaches can not be achieved, and only an operation via a transvenous approach is feasible. We aimed to study the feasibility of transarterial embolization of cavernous dural arteriovenous fistulas with a combination detachable coils and Onyx to embolize a complicated cavernous DAVF via a transvenous approach. Methods From August 2006 to August 2007, six cases of complicated cavernous DAVF were embolized with a combination of detachable coils and Onyx via a transvenous approach. Three cases were male and the other three were female. Their ages ranged from 36 to 69 years old. The fistula was in the right lateral cavernous sinus in one case, in the left lateral cavernous sinus in another, and in the bilateral cavernous sinus in 4 cases. One fistula was fed by the right internal carotid artery and its meningohypophyseal trunk; one was fed by the branches of the left internal carotid artery and left external carotid artery; four were fed by the branches of the bilateral internal carotid artery and/or the bilateral external carotid artery. One case was drained via one lateral inferior petrosal sinus; three were drained via bilateral inferior petrosal sinuses; one was drained via one lateral ophthalmic and facial veins; one was drained via the inferior petrosal sinus and the ophthalmic and facial veins. Four were embolized via the inferior petrosal sinus, and two were embolized via the ophthalmic and facial veins. Results Among six cases of complicated cavernous DAVF, four were fully embolized with Onyx by a single operation, and two cases were fully embolized with Onyx following two operations. Transient headache was found after operation in all patients, but was cured after several days by the symptomatic treatments. In one case, the first operation via the inferior petrosal sinus was a failure; the feeding branches of the external carotid artery were embolized, and transient facial palsy was appeared after operation. The fistula was fully embolized with Onyx via the inferior petrosal sinus after two months with no complications. One bilateral cavernous sinus DAVF was embolized with Onyx via the inferior petrosal sinus by two operations, and transient abducens nerve palsy occurred after embolization. Conclusions Because Onyx may be injected via a transvenous approach and the microcatheter is easily withdrawn, cavernous sinus via transvenous catheterization and embolization is a safe and efficient way to treat complicated cavernous dural arteriovenous fistulas, especially those for which operations via transarterial approaches have failed, or spontaneous cavernous dural arteriovenous fistulas.展开更多
Background Coronary artery fistula （CAF） is a rare anomaly.Transcatheter CAF closure has been introduced using various materials,but only few data are available on the Guglielmi detachable coil （GDC）.The advantage...Background Coronary artery fistula （CAF） is a rare anomaly.Transcatheter CAF closure has been introduced using various materials,but only few data are available on the Guglielmi detachable coil （GDC）.The advantage of using GDC for transcatheter CAF closure is more controllable,therefore much safer when compared to other coils.This report is about our experience in transcatheter closure of CAF using fibered GDC in our hospital.Methods ＆ Results From 2002 to 2007,there were 10 patients with CAFs （age range：28 to 56 year-old,7 males） who underwent transcatheter CAF closure.There were a total of 19 CAFs which originated from right coronary （n =5）,left circumflex （n =3）,left anterior descending artery （n =10） and left main trunk （n =1）.Median number of coil deployment for each fistula was 3 （range：1 to 6）.The pulmonary artery was the most common site of the distal communication of CAFs （n =14）,followed by right atrium （n =3）,left atrium （n =1） and left ventricle （n =1）.Immediate coronary angiography after GDC deployment revealed no residual shunt in 12 （63.2％） CAFs,significant reduction of the flow in 5 （26.3％）,while 2 （10.5％） could not be closed due to small size.Nine （90％） patients underwent a repeated angiography within 3 to 8 months.Among 12 CAFs that were occluded immediately post-deployment,there were 2 CAFs with insignificant residual flow.Among 6 CAFs with significantly decreased flow immediately post-deployment,2 were occluded totally in the follow-up angiography.In total,12 （70.5％） CAFs were occluded completely and 5 （29.5％） CAFs still had insignificant residual flow,which did not need any additional coil deployment.During a mean follow up of 4.3 ± 0.7 year,all patients remained symptom and complication free.Conclusions The fibered GDC is a safe and effective method for percutaneous closure of the CAFs.展开更多
Calcium alginate gel（CAG） has been shown to successfully model aneurysm embolization within a short period of time.However,gradually degrading CAG potentially results in aneurysm recanaliza-tion.In the present study...Calcium alginate gel（CAG） has been shown to successfully model aneurysm embolization within a short period of time.However,gradually degrading CAG potentially results in aneurysm recanaliza-tion.In the present study,a regenerative embolic material was designed by seeding rat fibroblasts in a CAG.The study investigated the feasibility of constructing a 3-dimensional culture system.The fibroblasts grew well and firmly attached to the CAG.CAG was conducive for fibroblast growth,and resulted in a 3-dimensional culture system.Results show that CAG can be used theoretically as a vascular,regenerative,embolic material.展开更多
Obejctive To develop a Chinese-made electrolytic detachable coil (CEDC) that would allow patients to enjoy the benefit of electrolytic detachable coil without having to rely on the expensive Guglielmi detachable coil...Obejctive To develop a Chinese-made electrolytic detachable coil (CEDC) that would allow patients to enjoy the benefit of electrolytic detachable coil without having to rely on the expensive Guglielmi detachable coil (GDC), and to test the safety and efficiency of CEDC Methods Radiopacity of the marker of the CEDC was tested The anti strain force of coils and connection points were measured In vitro and in vivo electrolyses were conducted We produced 21 aneurysm models including lateral, bifurcation, and terminal aneurysm models, and embolized 18 models with CEDC Results Radiopacity of the marker was satisfactory Anti strain of the coil and the connection point have shown the safety and efficiency of CEDC Electrolysis in vitro and vivo, was similar to that of GDC 83% of the aneurysm models were completely occluded Coils were found to induce thrombosis in the aneurysm cavity, and could lead to a new endothelium over the entrance of the aneurysm, with organized tissue replacing thrombosis in 2 months Conclusions CEDC is as efficient and safe as GDC The marker, the ability to induce thrombosis inside the sac and the growth of new endothelium over the orifice are very satisfactory展开更多
文摘Electrolytic detachable coils (EDC) have been the main embolic materi als for intracranial aneurysms. Liquid aneurysmal embolic materials represented by cellulose acetate polymer (CAP) are still in controversy. In this research, t he embolization results and pathological reactions after embolization of canine aneurysmal models with EDC or CAP were observed and compared. Methods. The canine aneurysmal models constructed by anastomosis of venous pouch es were randomly grouped. The aneurysms were respectively occluded with CAP and electrolytic detachable coils that was named by Wu electrolytic detachable coil (WEDC) and made by us. Angiogram follow ups were performed at 24 hour, 2 week , and 2 month after embolization. The occluded aneurysms were dissected in each stage for light microscopic, electron microscopic, and histochemical research. Results. The effect of embolization was significantly better with WEDC than that with CAP . Post embolized complications such as aneurysm rupture and stenosis of parent arteries could only be found in CAP group. Pathol ogical research showed that CAP mass could packed the aneurysms more densely tha n coils. Acute chemical damage of aneurysmal wall and inflammatory cell infiltra tion was prominently found in early stage after CAP embolization. Organization of thrombus inside aneurysms and formation of endothelial tissue over the orific es of aneurysmal necks could be found in both groups 2 months after embolization . But parts of coils might be exposed outside endothelial layer. Conclusions. EDC are still the most safe, efficient, and reliable instruments to embolize aneurysm. CAP should be improved further to solve the problem of stron g chemical corrosion and difficulty in control before it is widely used.
基金This work was originally published in the Chinese Journal of Neuro-surgery (2001 17(2): 87-90) in Chinese.
文摘Objective. To compare the embolization effects of intracranial aneurysms with mechanical detachable spirals (MDS) and with Guglielmi detachable coils (GDC).Methods. One hundred and twenty cases with 125 intracranial aneurysms were embolized in Beijing Hospital from March 1995 to July 1999. Sixty - six aneurysms in 64 cases were embolized with MDS, 51 in 48 with GDC, and 8 in 8 with both MDS and GDC. Clinical data including sex, age, subarachnoid hemorrhage (SAH), Hunt & Hess grading, diameter and neck width of aneurysms, number and length of coils used per aneurysm, occlusive ratio, and complications were compared between MDS and GDC groups.Results. MDS and GDC groups were comparable (t-test or x2 -test, all P value > 0. 10) in terms of age, sex, diameter of aneurysms [ (8. 46 ± 3. 42) mm vs. (7. 38 ± 3. 45) mm], neck width [ (3. 49 ± 1. 50) mm vs. (3. 26 ± 1. 52) mm], coils number[ (4. 65 ± 3. 01) vs. (4. 24 ± 2. 65) ] and their length[ (460. 2 ± 398. 5) mm vs. (422. 9 ±387. 1) mm] used per aneurysm, occlusive ratio in aneurysms embolized ≥80% [ (95. 00% ± 6. 32% ) vs. (94. 19% ± 7. 63% ) ], mortality and permanent complications (7. 8% vs. 4. 2% ).Conclusions. MDS and GDC are all materials for embolization of intracranial aneurysms. MDS is less expensive, but more difficult to control and of propensity to complications while GDC is more compliant, easier to be used, safer, and have many alternative types for use as well as more extensive indications.
文摘Background Treatment of cavernous dural arteriovenous fistulas （DAVF） is usually made by a transarterial approach. However, in many complicated patients, treatments via transarterial approaches can not be achieved, and only an operation via a transvenous approach is feasible. We aimed to study the feasibility of transarterial embolization of cavernous dural arteriovenous fistulas with a combination detachable coils and Onyx to embolize a complicated cavernous DAVF via a transvenous approach. Methods From August 2006 to August 2007, six cases of complicated cavernous DAVF were embolized with a combination of detachable coils and Onyx via a transvenous approach. Three cases were male and the other three were female. Their ages ranged from 36 to 69 years old. The fistula was in the right lateral cavernous sinus in one case, in the left lateral cavernous sinus in another, and in the bilateral cavernous sinus in 4 cases. One fistula was fed by the right internal carotid artery and its meningohypophyseal trunk; one was fed by the branches of the left internal carotid artery and left external carotid artery; four were fed by the branches of the bilateral internal carotid artery and/or the bilateral external carotid artery. One case was drained via one lateral inferior petrosal sinus; three were drained via bilateral inferior petrosal sinuses; one was drained via one lateral ophthalmic and facial veins; one was drained via the inferior petrosal sinus and the ophthalmic and facial veins. Four were embolized via the inferior petrosal sinus, and two were embolized via the ophthalmic and facial veins. Results Among six cases of complicated cavernous DAVF, four were fully embolized with Onyx by a single operation, and two cases were fully embolized with Onyx following two operations. Transient headache was found after operation in all patients, but was cured after several days by the symptomatic treatments. In one case, the first operation via the inferior petrosal sinus was a failure; the feeding branches of the external carotid artery were embolized, and transient facial palsy was appeared after operation. The fistula was fully embolized with Onyx via the inferior petrosal sinus after two months with no complications. One bilateral cavernous sinus DAVF was embolized with Onyx via the inferior petrosal sinus by two operations, and transient abducens nerve palsy occurred after embolization. Conclusions Because Onyx may be injected via a transvenous approach and the microcatheter is easily withdrawn, cavernous sinus via transvenous catheterization and embolization is a safe and efficient way to treat complicated cavernous dural arteriovenous fistulas, especially those for which operations via transarterial approaches have failed, or spontaneous cavernous dural arteriovenous fistulas.
文摘Background Coronary artery fistula （CAF） is a rare anomaly.Transcatheter CAF closure has been introduced using various materials,but only few data are available on the Guglielmi detachable coil （GDC）.The advantage of using GDC for transcatheter CAF closure is more controllable,therefore much safer when compared to other coils.This report is about our experience in transcatheter closure of CAF using fibered GDC in our hospital.Methods ＆ Results From 2002 to 2007,there were 10 patients with CAFs （age range：28 to 56 year-old,7 males） who underwent transcatheter CAF closure.There were a total of 19 CAFs which originated from right coronary （n =5）,left circumflex （n =3）,left anterior descending artery （n =10） and left main trunk （n =1）.Median number of coil deployment for each fistula was 3 （range：1 to 6）.The pulmonary artery was the most common site of the distal communication of CAFs （n =14）,followed by right atrium （n =3）,left atrium （n =1） and left ventricle （n =1）.Immediate coronary angiography after GDC deployment revealed no residual shunt in 12 （63.2％） CAFs,significant reduction of the flow in 5 （26.3％）,while 2 （10.5％） could not be closed due to small size.Nine （90％） patients underwent a repeated angiography within 3 to 8 months.Among 12 CAFs that were occluded immediately post-deployment,there were 2 CAFs with insignificant residual flow.Among 6 CAFs with significantly decreased flow immediately post-deployment,2 were occluded totally in the follow-up angiography.In total,12 （70.5％） CAFs were occluded completely and 5 （29.5％） CAFs still had insignificant residual flow,which did not need any additional coil deployment.During a mean follow up of 4.3 ± 0.7 year,all patients remained symptom and complication free.Conclusions The fibered GDC is a safe and effective method for percutaneous closure of the CAFs.
文摘Calcium alginate gel（CAG） has been shown to successfully model aneurysm embolization within a short period of time.However,gradually degrading CAG potentially results in aneurysm recanaliza-tion.In the present study,a regenerative embolic material was designed by seeding rat fibroblasts in a CAG.The study investigated the feasibility of constructing a 3-dimensional culture system.The fibroblasts grew well and firmly attached to the CAG.CAG was conducive for fibroblast growth,and resulted in a 3-dimensional culture system.Results show that CAG can be used theoretically as a vascular,regenerative,embolic material.
文摘Obejctive To develop a Chinese-made electrolytic detachable coil (CEDC) that would allow patients to enjoy the benefit of electrolytic detachable coil without having to rely on the expensive Guglielmi detachable coil (GDC), and to test the safety and efficiency of CEDC Methods Radiopacity of the marker of the CEDC was tested The anti strain force of coils and connection points were measured In vitro and in vivo electrolyses were conducted We produced 21 aneurysm models including lateral, bifurcation, and terminal aneurysm models, and embolized 18 models with CEDC Results Radiopacity of the marker was satisfactory Anti strain of the coil and the connection point have shown the safety and efficiency of CEDC Electrolysis in vitro and vivo, was similar to that of GDC 83% of the aneurysm models were completely occluded Coils were found to induce thrombosis in the aneurysm cavity, and could lead to a new endothelium over the entrance of the aneurysm, with organized tissue replacing thrombosis in 2 months Conclusions CEDC is as efficient and safe as GDC The marker, the ability to induce thrombosis inside the sac and the growth of new endothelium over the orifice are very satisfactory
