摘要
目的通过国产机械可脱式弹簧圈(MDS)的动物试验及临床初步应用,观察其操作性能及致血凝性。方法利用中国白兔建立分叉部位动脉瘤模型,2周后进行国产机械可脱式弹簧圈的栓塞。5个动脉瘤共使用弹簧圈24枚。2~3周后造影复查,并处死动物,取出动脉瘤标本进行病理检查。临床应用于10例患者的栓塞,其中动脉瘤7例,外伤性颈内动脉海绵窦瘘(CCF)2例,海绵窦区硬脑膜动静脉瘘(DAVF)1例。共使用弹簧圈146枚,均用MDS推导系统操作。结果病理检查示兔动脉瘤被弹簧圈不同程度填塞(2例完全,3例次全),陈旧及机化的血栓填充弹簧圈之间,与血流接触面有内皮细胞生长。操作过程中,国产弹簧圈与MDS推导系统配合较好,叩合、推导、回拉及解脱顺利。结论国产机械可脱式弹簧圈与进口MDS推导系统相匹配,操作可靠安全,有较好致血凝性,并可诱发内皮细胞生长封闭瘤口。
Objective To evaluate the practical and thrombogenetic characteristics of selfmade mechanically detachable coils by the animal experiment and primary clinical application. Method The bifurcation type of aneurysm model was established on rabbit and embolized with selfmade mechanically detachable coils 2 weeks after surgery. 24 coils were used in 5 experimental aneurysms.Control angiography was performed and the rabbits were sacrificed 2 ̄3 weeks after the embolization.The embolized aneurysm samples were examined by pathologist.Ten patients were treated with selfmade mechanically detachable coils in primary clinical application.They were divided into aneurysms(7 patients), traumatic carotidcarvenous fistulas (2),dural arteriovenous fistula in carvenous sinus region (1).146 coils were used totally and all were delivered with mechanical detachable system (MDS Balt co.France). Result Pathologically,the cavities of rabbit aneurysm models were occluded by tungsten coils (2 complete,3 almost complete).The coils were trapped in granulation tissue which was covered by a thin layer of endothelium on the surface facing the blood flow.In the coils dense packing ones,the aneurysms were completely excluded from the parent circulation by neointimal layers.In the practice procedures,the coils fit MDS (Balt co.France) very well and can be delivered,withdrew and detached smoothly. Conclusion The selfmade mechanically detachable coils have practical reliability and evident thrombogenetic effects.
出处
《中华外科杂志》
CAS
CSCD
北大核心
1998年第7期392-394,I079,共4页
Chinese Journal of Surgery