可脱性球囊栓塞治疗颈内动脉海绵窦瘘

目的 总结经动脉途径可脱性球囊性栓塞治疗２０便颈内动脉海绵窦瘘的经验。方法 采用Ｍａｇｉｃ－ＢＤ球囊导管和带标记乳胶球囊,在Ｘ线电视屏幕监视下,经股动脉插管。在球囊内注入渗量等渗非离子造影剂闭塞瘘口。结果 ２０例全部治愈,１次栓塞成功１６例。２次栓塞成功４例,颈内动脉通畅率７０％,无并发症。结论本方法可作为颈内动脉海绵窦瘘的首选治疗方法,尽可能保留颈内动脉通畅,如侧枝循环好,亦可闭塞患侧颈内动脉。     

脑动脉瘤栓塞疗法完美实施的基础

目的：探索栓塞疗法治疗脑动脉瘤达到理想结果的条件。方法：１９９６年４月至２０００年４月间栓塞治疗３３例动脉瘤患者。以球囊栓塞４例,以机械解脱式钨丝弹簧圈栓塞２０例,以电解脱式铂金弹簧圈栓塞９例。结果：闭塞载瘤动脉４例,１００％闭塞８例,９５％闭塞１５例,９０％闭塞６例。无手术并发症。随访（门诊或信访）３３例无再出血。造影随访８例,其中术后１个月复查造影的２例均保持术后栓塞程度,术后３个月复查的３例     

Measuring arterial strain induced by endovascular stents

Endovascular stents are expandable, fenestrated tubes that are threaded in their collapsed state through an artery to a site of occlusion, plastically enlarged and left as permanent implants to scaffold the artery open. The stent induces large-scale vascular strains that are difficult to measure in vivo and yet can be critical determinants of stent-vessel biology. A method is developed to measure the strain tensor developed on the surface of an artery as a stent is expanded in vivo. Arterial sections are marked with reference points and imaged as the stent is expanded. An axially symmetric parametric model of the artery is determined for each expansion time-point, and these reference points are back-projected onto this surface. The back-projected reference points are grouped and analysed to determine the circumferential, axial and torsional strain tensor components in each arterial subsection. The method is characterised in vitro using bovine artery segments and a latex phantom, and is then tested on rabbits to demonstrate its feasibility in vivo. In vitro experiments on stented bovine arteries show typical post-stenting strains of 0.60, -0.26, and 0.08 mm mm-1 in the circumferential, axial and torsional directions, respectively, sampled every 1 mm along the length of the stented region. Phantom experiments characterise the RMS error of system measurements as 0.1 mm mm-1. The system is shown capable of measuring strains of straight, accessible vessels in the presence of respiratory/cardiac motion and visual glare in vivo.     

两种方法治疗颅内动脉瘤疗效比较

目的 比较神经外科手术夹闭与血管内介入术治疗颅内动脉瘤的疗效.方法 回顾性分析110例颅内动脉瘤患者的临床资料,按治疗方法不同分为介入组(55例,行血管内介入治疗)、手术组(55例,行神经外科手术夹闭治疗),术后随访1～4个月,即时进行术后疗效评价,采用中国脑卒中量表(CSS)和日常生活能力(ADL)两项评分进行预后评价.结果 术后即时疗效:介入组显效40例、有效10例、无效5例、总有效率90.9％,手术组分别为32例、10例、13例、76.4％,两组总有效率差异有统计学意义(x2=3.96,P＜0.05).术后随访,两组CSS和ADL评分均较治疗前明显降低(t=9.12、8.05,均P＜0.05)；介入组较手术组降低更明显(t=7.35、5.67,均P＜0.05).结论 行血管内介入治疗颅内动脉瘤可提高临床疗效和患者生活自理能力,明显改善预后.     

Abdominal Aortic Aneurysms: Endovascular Options and Outcomes — Proliferating Therapy,But Effective?

Abdominal aortic aneurysm (AAA) has a reported prevalence rate of 1.4% in the US. AAA rupture accounts for an estimated 15,000 deaths per year, rendering it the 10th leading cause of death in men over the age of 55. Endovascular repair (EVR) has proliferated in the last two decades as an increasingly popular alternative to traditional open surgery, and is now the default treatment in the majority of centres worldwide. This review article outlines the evidence supporting this stance. The development of EVR is reviewed, alongside trends in utilisation of this therapy over time. The evidence for the relative short-term and long-term outcomes of EVR and open AAA repair is discussed, and ongoing controversies surrounding the use of EVR are considered.     

Multiphoton microscopy for pre-clinical evaluation of flow-diverter stents for treating aneurysms

BackgroundConventional histological analyses are the gold standard for the study of aneurysms and vascular pathologies in pre-clinical research. Over the past decade, in vivo and ex vivo imaging using multiphoton microscopy have emerged as powerful pre-clinical tools for detailed tissue analyses that can assess morphology, the extracellular matrix (ECM), cell density and vascularisation. Multiphoton microscopy allows for deeper tissue penetration with minor phototoxicity.ObjectiveThe present study aimed to demonstrate the current status of multimodality imaging, including multiphoton microscopy, for detailed analyses of neo-endothelialisation and ECM evolution after flow-diverter stent (FDS) treatment in an experimental rabbit model of aneurysms.MethodsMultiphoton microscopy tools for assessing autofluorescence and second harmonic generation (SHG) signals from biological tissues were used to evaluate the endovascular treatment of intracranial aneurysms in an animal model of aneurysms (pig, rabbit). Results from multiphoton microscopy were compared to those from standard histology, electronic and bright field microscopy.ConclusionsThe present study describes novel evaluation modes based on multiphoton microscopy for visualising tissue morphology (e.g., collagen, elastin, and cells) to qualify and quantify the extent of neo-intimal formation of covered arteries and device integration into the arterial wall using a rabbit model of intracranial aneurysms treated with FDS.