基于血管腔内重建技术的新型内皮祖细胞捕获脑血管覆膜支架的实验研究

颅内复杂性动脉瘤（巨大、梭形、夹层和假性动脉瘤）一直以来都是血管腔内治疗和外科手术夹闭的难题。鉴于脑动脉瘤是一种母体血管管壁缺陷性疾病，血管腔内隔绝技术有望克服目前瘤腔内栓塞技术的缺陷，达到重建载瘤血管，完全闭塞动脉瘤腔的治疗效果。本课题组研制的球扩式覆膜支架为难治性脑动脉瘤提供了新的治疗方法，然而，该覆膜支架尚存在支架整体顺应性差，在以迂曲为特点的母体动脉内贴壁不良、瘤口封堵不满意，以及靶病变到位率低的不足，外覆膜材造成内皮化延迟，增加了支架内血栓形成和再狭窄风险。本课题拟从支架骨架和膜材料选择、结构设计、释放方式、输送系统等方面着手，研发一种具有顺应性好、支撑力足，直接隔绝动脉瘤口，改变动脉瘤腔血流动力学，促进病变自行愈合，同时通过缓释CD34抗体捕获体循环内皮祖细胞以达到保持母体动脉长期通畅的新型脑血管专用覆膜支架，并通过植入治疗兔动脉瘤模型，评价其体内应用的可行性、安全性和有效性.

Complicated cerebral aneurysm, such as giant, fusiform, dissecting and pseudo aneurysms, has always become a difficulty either for endovascular embolism or surgical clipping. Considering that the cerebral aneurysm is kind of arterial wall deficiency disease, endovascular treatment for isolation of the aneurysm sac is likely to overcome the insufficiency of coil embolism to achieve parent artery reconstruction and complete aneurysm occlusion. Despite that the balloon-expandable fully covered stent we invented has provide a new treatment option for complicated cerebral aneurysms in clinical with a satisfied total occlusion rate, however, in view of the deficiency of materials and stent design, it has limitations including unsatisfied flexibility, poor arterial wall adherence ability and low target lesion arrive rate. Moreover, the delayed endothelialization caused by coverage material is likely to cause in-stent thrombosis and stenosis. Consequently, we are trying to make an improvement from stent/membrane material, structure design, release manner, and the delivery system to enhance its flexibility and radio force to achieve better aneurysm neck occlusion and significant hemodynamic flow reverse in aneurysm sac to promote aneurysm healing, while the controlled releasing of CD34 antibody can capture endothelial progenitor cells to keep better patency of the parent artery. Furthermore, this stent is also supposed to be used in a rabbit aneurysm model to assess its feasibility, safety and efficacy in vivo.