Local metabolism in severe brain injury and hypothermia. [Investigation of Endothelial Cell Proliferation on the Coil Surface after Endovascular Treatment Using Factor XIII : Preliminary Results in Swine Model]

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Because of few cases of severe brain injury which could be treated by hypothermia, we performed an experimental research of treatment of severe brain injury caused by subarachnoid hemorrhage due to ruptured cerebral aneurysm. In patients with severe brain injury due to ruptured cerebral aneurysm, intravascular treatment using detachable coils are now being often used and however, this method can not yet be called as an established treatment because the method have been introduced only a few years before and the mechanism of cure of coiled aneurysms have not been clarified. The method and results : Fourteen aneurysms were produced in seven matured swine and embolized with Guglielmi Detachable coils (GDCs). The aneurysms were resected either immediately or 3 weeks after coil embolization, and subjected to histological and scanning electron microscopic examinations. Blood coagulation factor XIII was administrated in 4 animals on the day of embolization and following 4 days. These aneurysms were also resected 3 weeks after the embolization and investigated histologically. Marked fibroblast proliferation and growth of endothelial cells on the intraluminal surface of the coil were observed more often in the group administrated factor XIII than in those not given factor XIII.These results suggest that administration of factor XIII may contribute to more effective aneurysm obliteration during coil embolization.