Model analysis of coil embolization of cerebral aneurysms: prediction of thrombus formation in aneurysms based on the coil embolization rate
Model analysis of coil embolization of cerebral aneurysms: prediction of thrombus formation in aneurysms based on the coil embolization rate
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DOI：
10.1179/016164106x98044
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发表时间：
2006-03-01
影响因子：
1.9
通讯作者：
Kuroiwa, T
中科院分区：
文献类型：
--
作者：
Shimano, H;Nagasawa, S;Kuroiwa, T
目的：动脉瘤内弹簧圈栓塞术已成为脑动脉瘤血管内治疗的常用方法，但很少有研究评价其远期疗效。由于完全栓塞术尚无足够的客观标志，其应用取决于外科医生的经验。方法：制作玻璃脑动脉瘤模型，观察动脉瘤内血流动力学的变化。模型的填充材料为直径0.33 mm的尼龙线，与临床常用的栓塞圈相似。用甘油溶液灌流代表人血后，光学测量注入动脉瘤内的一种染料的半衰期，并研究半衰期与尼龙线在动脉瘤中的体积栓塞率(VER)的关系。结果：在动脉瘤中填充尼龙线获得的最大VER为41.7+/-2.9%。染料的半衰期随VER的增加而增加，在VER；30%时显著增加。讨论：该染料在动脉瘤中的半衰期反映了动脉瘤内血流动力学的停滞，提示半衰期的延长促进了血栓的形成。这项研究的结果表明，VER>；30%对于有效的弹簧圈栓塞是足够的。
Objectives: Intra-aneurysmal coil embolization has been established as a common method for the intravascular treatment of cerebal aneurysms, but few studies have evaluated its long-term results. Because there is no sufficient objective landmark of complete embolization, determination of its application depends on a surgeon's experience.Methods: A glass cerebral aneurysm model was produced, and the changes in intra-aneurysmal hemodynamics were examined. Nylon thread with a diameter of 0.33 mm, resembling the coils clinically used for embolization, was used to fill in the model. After perfusion of glycerin solution to represent human blood, the half life of a dye injected into the aneurysm was optically measured, and the relationship between the half life and the volume embolization rate (VER) of nylon thread in the aneurysm was examined.Results: The maximal VER obtained by filling nylon thread in the aneurysm was 41.7 +/- 2.9%. The half life of the dye increased with the VER and was significantly increased at VER > 30%.Discussion: The half life of the dye in the aneurysm reflected stagnation of intra-aneurysmal hemodynamics, suggesting that the prolongation of the half life enhances thrombus formation. The results of this study suggested that VER > 30% is sufficient for effective coil embolization.