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目的 研制国产带膜支架并探讨动脉瘤腔内治疗的可行性 ,观察治疗后病理变化。方法 以镍钛记忆合金 (Nitinol)及国产真丝人造血管为材料制作带膜支架 ;以腹直肌后鞘及Dacron补片制作动脉瘤模型 ;通过输送系统在X线透视下将带膜支架安装在动脉瘤模型的恰当位置 ,使动脉瘤完全得到旷置 ;随访 7d至 12个月收集标本观察支架放置后病理改变。结果 12只杂种犬模型9只动脉瘤腔内治疗效果满意 ,2例出现并发症 ,1例失败。术后病理变化 :支架放置 7d后动脉壁呈急性炎性改变 ,1个月后支架内壁有光滑半透明纤维素薄膜形成 ,3个月后支架两端新生血管内皮生长达到高峰。结论 腔内架桥治疗动脉瘤具有技术操作简便、创伤小、恢复快的优点。所构建的国产带膜支架在动物模型中治疗效果满意 ,可望应用于临床进一步观察
Objective To develop a domestic stent-graft and explore the feasibility of endovascular treatment of aneurysms and observe the pathological changes after treatment. Methods Nitinol and domestic silk vascular prostheses were used as the material to make the stent-graft. The aneurysm model was made with the rectus abdominis sheath and Dacron patch. The stent-graft was installed under X-ray fluoroscopy Aneurysm model of the appropriate location, so completely aneurysm exclusion; follow-up 7d to 12 months after the collection of specimens were observed pathological changes after placement. Results Endovascular treatment of 9 aneurysms in 12 hybrid dogs was satisfactory, 2 cases had complications and 1 case failed. Postoperative pathological changes: 7d after stent placement, the arterial wall showed acute inflammatory changes, and the inner wall of the stent was formed with a smooth translucent cellulose film after 1 month. The vascular endothelial growth peaked at both ends of the stent after 3 months. Conclusions The treatment of aneurysms by intracavitary bridging has the advantages of simple technique, less trauma and faster recovery. The constructed domestic stent-graft in the animal model of treatment is satisfactory, is expected to be used in clinical further observation