Use of a new mixture for embolization of intracranial vascular malformations
Use of a new mixture for embolization of intracranial vascular malformations
复制标题
使用新型混合物栓塞颅内血管畸形
作者：
P. Lylyk;F. Viñuela;H. Vinters;J. Dion;J. Bentson;G. Duckwiler;T. Lin
猪的颈内动脉系统具有类似于脑“动脉-动脉畸形”的特殊解剖结构。颈内动脉破裂成许多细小的通道（网），位于脑垂体一侧的颅底。该解剖动脉模型用于分析用I）avitene、II）avitene和50%乙醇、III）avitene、30%乙醇和聚乙烯醇、IV）avitene 50%乙醇和聚乙烯醇、V）IBCA和VI）丝闭塞奇异网后的急性和慢性血管造影和组织学变化。闭塞6周后，观察到的奇异网组织学变化表明，阿替烯、30%乙醇和聚乙烯醇和IBCA的混合物产生最佳的解剖结果。与IBCA相比，用avitene、PVA和乙醇栓塞诱导的组织学反应更温和。在AVM手术切除的病例中，这种混合物的初步临床经验令人放心。部分血栓形成的AVM很容易被神经外科医生压下和压缩，使得AVM病灶内和周围的止血效果令人满意。
SummaryThe internal carotid artery system in swine has a special anatomic configuration similar to a brain “arterial-arterial malformation”. The internal carotid artery breaks up into a multitude of fine channels (rete mirabile) situated at the base of the skull on the side of the hypophysis. This anatomic arterial model was used to analyze acute and chronic angiographic and histological changes after occlusion of the rete mirabile with I) avitene, II) avitene, and 50% ethanol, III) avitene, 30% ethanol and Polyvinyl alcohol, IV) avitene 50% ethanol and Polyvinyl alcohol, V) IBCA and VI) silk. Histopathological changes observed in the rete mirabile six weeks following occlusion demonstrated that a mixture of avitene, 30% ethanol and Polyvinyl alcohol and IBCA produced the best anatomic results. Embolization with avitene, PVA and ethanol induced a more bland histological reaction than the one observed with IBCA. Preliminary clinical experience with this mixture is reassuring in those cases in which the AVM was surgically resected. The partially thrombosed AVM was easily depressed and compressed by the neurosurgeon allowing for satisfactory hemostasis in and around the nidus of the AVM.