A proposed ordinal scale for grading histology in elastase-induced, saccular aneurysms.
A proposed ordinal scale for grading histology in elastase-induced, saccular aneurysms.
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发表时间：
2006
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通讯作者：
D. Dai;Y. Ding;D. A. Lewis;D. Kallmes
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作者：
D. Dai;Y. Ding;D. A. Lewis;D. Kallmes
背景与目的弹性蛋白酶诱导的兔动脉瘤模型虽然应用广泛，但仍无法提供组织学结果的定量或定性指标。本研究旨在建立这样一个量表来评估结果，并促进对动脉瘤治疗设备进行有意义的临床前比较。材料与方法制备弹性酶诱导的动脉瘤并栓塞30只家兔。动脉瘤在2到24周之间被切除。标本包埋石蜡，切片，苏木精和伊红染色。该量表包括3个子类别：再通/线圈压实的范围和程度；颈部愈合，基于颈部组织的厚度和类型；还有穹顶愈合。颈部愈合通过肉眼和显微镜检查进行评估。通过血管造影和组织学图像评估压实度。仅通过显微图像评估穹窿愈合。对定量数据采用方差分析，对非参数数据采用Kruskal-Wallis检验。结果：随着时间的推移，我们注意到显著的主效应（P = 0.0016）。事后检验显示，2周时的平均评分为1.4 +/- 0.8，而24周时的平均评分为7.2 +/- 1.6 （P < or = 0.05）。此外，窄颈动脉瘤（6.0 +/- 1.3）和宽颈动脉瘤（3.5 +/- 1.1）在4周时的愈合有显著差异（P = 0.0433）。该量表的动态范围似乎也是合适的，因为在量表的上部有足够的范围来反映未来设备可能实现的愈合改善。结论：该量表是血管内治疗后弹性酶诱导动脉瘤的潜在相关结果测量工具。还需要进一步的研究来证实其实际意义。
BACKGROUND AND PURPOSE The elastase-induced aneurysm model in rabbits, though widely applied, still offers no quantitative or qualitative metric for histologic outcome. This study is aimed at producing such a scale to evaluate outcome and facilitate meaningful, preclinical comparison among devices proposed for aneurysm treatment. MATERIAL AND METHOD Elastase-induced aneurysms were created and embolized in 30 rabbits. Aneurysms were harvested between 2 and 24 weeks. Specimens were embedded in paraffin, sectioned, and stained with hematoxylin and eosin. The scale comprised 3 subcategories: extent and degree of recanalization/coil compaction; neck healing, based on thickness and type of tissue across the neck; and dome healing. Neck healing was assessed by both gross and microscopic inspections. Compaction was assessed by using both the angiographic and histologic images. Dome healing was assessed by using the microscopic images only. Data were analyzed with either analysis of variance for the quantitative data or Kruskal-Wallis tests when analyzing the nonparametric data. RESULTS We noted a significant main effect for healing over time (P = .0016). Post hoc tests showed that, at 2 weeks, the mean score was 1.4 +/- 0.8, as compared with a mean score of 7.2 +/- 1.6 for the 24-week time point (P < or = .05). Further, significant differences in healing between narrow-necked (6.0 +/- 1.3) and wide-necked aneurysms (3.5 +/- 1.1) were seen at 4 weeks (P = .0433). The dynamic range of the scale also appears to be appropriate, because there was adequate range at the upper portion of the scale to reflect improved healing that might be achieved with future devices. CONCLUSIONS This scale is a potentially relevant outcome measurement tool for elastase-induced aneurysms after endovascular therapy. Future studies are still required to confirm its practical relevance.