微弹簧圈瘤腔栓塞治疗假性动脉瘤的实验研究

目的以微弹簧圈（ＭＣ）瘤腔栓塞治疗兔颈总动脉创伤性假性动脉瘤（ＴＰＡ），评价其长期疗效。方法在１６只兔的 右侧颈总动脉制作创伤性假性动脉瘤。将术后３～４周存留的１２个ＴＰＡ兔模型随机分为对照组与ＭＣ瘤腔栓塞组，分 别给予相应的治疗。栓塞治疗后３个月复查数字减影血管造影（ＤＳＡ），并做病理检查。结果对照组３只兔未接受任何 治疗，均死于ＴＰＡ破裂出血。ＭＣ瘤腔栓塞组中４只兔闭塞全部瘤腔、４只兔闭塞大部瘤腔、ｌ只兔发生ＭＣ脱入载瘤 动脉。栓塞术后３个月复查ＤＳＡ见４只全部瘤腔闭塞者仍完全闭塞，载瘤动脉通畅，局部解剖发现ＴＰＡ原有结构消 失，取而代之的是一团瘢痕组织。栓塞大部瘤腔的４只兔未发生进一步的栓塞，ＭＣ有再压缩现象。统计分析显示两者 均有防止ＴＰＡ破裂出血的治疗效果（Ｐ＝０．０２９）。结论采用ＭＣ瘤腔栓塞ＴＰＡ可以达到完全闭塞瘤腔，保留载瘤动脉 通畅的效果；瘤腔部分栓塞亦有防止ＴＰＡ破裂出血的效果。

Endovascular embolization with microcoils of traumatic pseudoaneurysm in the common carotid artery in rabbits

Objective: To evaluate the long-term effect of endovascular occlusion with microcoils (MC) of experimental traumatic pseudoaneurysm (TPA) in the common carotid artery in rabbits. Methods TPAs in the right common carotid artery were surgically induced inl6 rabbits. Three to four weeks postoperatively, 12 rabbits survived were randomly divided into control group and occlusion group in which the TPAs were embolized with MC. Three months after embolizaton, the TPAs were examined by digital subtraction angiography (DSA) and pathologically. Results Three control rabbits without treatment all died of TPA rupture. In the occlusion group, the TPAs of 4 rabbits were completely occluded and partially in another 4 while the MC fell off into the artery in 1 rabbit. Three months after the embolizaiton, the 4 completely occluded TPAs remained closed as determined by DSA findings, the parent artery was unobstructed and the TPAs were replaced by a mass of scar tissue. Rupture did not occur in the 4 partially occluded TPAs and recompression of the MC was observed. Conclusions TPA can be cured by complete occlusion with MC and the circulation through the artery is not affected. Imcomplete occlusion may also be beneficial for preventing the rupture of TPA.