【摘要】 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30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30头家猪的30个RBM进行栓塞,栓塞后28例动物存活良好。复查造影20例,18例未出现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。更多还原

【Abstract】 Objective To embolize swine rete mirabile ( RMB) with poly ( N -isopropylacrylamide) ( PNIPAM) and investigate its embolic feasibility as an embolic agent in cerebral arteriovenous malformations (AVMs) . Methods RMB embolization was performed in 30 swine. Follow-up angiography was performed for embolic efficacy. Embolized RMBs were examined histopatholgically and the alterations of inside RMB and the surrounding tissue were observed. Results RMB embolization was performed in 30 swine, 28 swine survived the embolization. Follow-up angiography was performed in 20 swine, there was no RMB recanalization in 18 swine. Histopatholgically, the copolymer was found diffused in vessels of 100~200μm in diameter. In acute group, neutrophilic granulocytes scattered surrounding the copolymer, endothelial integrity was observed, without endothelial denuding and necrosis. In subacute and chronic groups, the copolymer was still found inside RMBs, scattered mononuclear cells and eosinocytes were found inside and surrounding it. The muscular layer was loosened like ischemia, with most muscular nuclei degraded. Conclusion As a thermosensitive embolic material, the PNIPAM has optimized characteristics including embolic instability, better biocompatibility, radiopacity and non -adhesiveness, could be regarded as a new liquid embolic material in endovascular treatment of cerebral AVMs.更多还原