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目的应用聚氮异丙基丙烯酰胺(PNIPAM)栓塞猪的颅底微血管网(RMB),探讨其栓塞脑动静脉畸形(AVM)的可行性。方法栓塞36头猪的RMB,血管造影随访栓塞效果。组织学检查,观察栓塞血管及其周围改变。结果对36头家猪的RMB进行栓塞,栓塞后34头动物存活良好。复查造影24头,21头未出现RMB血管再通。组织学见栓塞剂在血管内可弥散到直径为100～200μm的血管腔内。急性期,微血管腔内共聚物周围可见中性粒细胞,内膜完整,无剥脱和坏死。亚急性期和慢性期,微血管腔内仍可见共聚物存在,可见散在的单核细胞和嗜酸性粒细胞。肌层松散,大部分细胞核降解,呈缺血样改变。结论PNIPAM对AVM模型栓塞稳定,生物相容性好,不透X线,不粘管,可作为脑AVM血管内治疗的一种新型液体栓塞材料。
Objective To evaluate the feasibility of embolization of cerebral arteriovenous malformations (AVM) with polyeptide-polyacrylamide (PNIPAM) in swine pig’s cranial basement microvascular network (RMB). Methods 36 pigs embolized RMB, angiography follow-up embolization effect. Histological examination was performed to observe the changes of embolized blood vessels and their surroundings. Results The RMB of 36 domestic pigs were embolized, and 34 animals survived well after embolization. Review of contrast 24, 21 did not appear RMB vascular recanalization. Histology see embolic agent in the blood vessels can be dispersed to a diameter of 100 ~ 200μm vascular lumen. Acute phase, microvascular lumen within the copolymer visible neutrophils, endometrial integrity, no exfoliation and necrosis. Subacute and chronic phase, the microvascular lumen is still visible in the presence of copolymer, showing scattered mononuclear cells and eosinophils. Muscle loose, most of the nucleus degradation, showed ischemic changes. Conclusions PNIPAM is a new type of liquid embolic material for AVM endovascular treatment of AVM with stable embolism, good biocompatibility, impervious X-ray and non-sticky tube.