CAJ | 학술논문

目的：探讨采用可降解镁合金覆膜支架治疗兔颈总动脉侧壁型动脉瘤的可行性。方法20只普通级新西兰大白兔，结扎左侧颈总动脉，1个月后行颈部MRA检查。挑选双侧椎动脉不增粗或略增粗，而右颈总动脉增粗的兔制作右侧颈总动脉动脉瘤模型。采用间断式外翻缝合法将兔静脉囊与颈总动脉吻合，建立右侧颈总动脉侧壁型动脉瘤模型。动脉瘤模型制作成功后2周行可降解镁合金覆膜支架或Willis覆膜支架植入术。支架植入后3、6和12个月行血管造影检查，评价支架植入后动脉瘤的情况及载瘤侧颈总动脉通畅情。支架植入后2周及1、2、4、6、9、12个月行钼靶检查，评价镁合金支架的可降解情况。结果20只实验兔左侧颈总动脉均顺利被结扎。结扎1个月后MRA检查示17只兔颈总动脉增粗，而双侧椎动脉增粗不明显或无增粗，右侧颈总动脉动脉瘤模型均建模成功。9个动脉瘤成功植入镁合金覆膜支架，8个动脉瘤成功植入Willis覆膜支架。支架植入后即刻造影示所有动脉瘤腔闭塞，右颈总动脉通畅。术后3个月复查血管造影，9个植入镁合金覆膜支架的动脉瘤腔完全闭塞，且右颈总动脉通畅；8个植入Willis覆膜支架的动脉瘤腔完全闭塞，其中7只兔右颈总动脉通畅，1只兔右颈总动脉闭塞。术后6、12个月复查，16只兔侧壁动脉瘤消失，右颈总动脉通畅。钼靶显示镁合金支架植入后随时间的延长而逐步降解，而Willis支架仍保持原有的结构和形状。结论可降解镁合金覆膜支架治疗兔颈总动脉侧壁型动脉瘤具有可行性。
목적：탐토채용가강해미합금복막지가치료토경총동맥측벽형동맥류적가행성。방법20지보통급신서란대백토，결찰좌측경총동맥，1개월후행경부MRA검사。도선쌍측추동맥불증조혹략증조，이우경총동맥증조적토제작우측경총동맥동맥류모형。채용간단식외번봉합법장토정맥낭여경총동맥문합，건립우측경총동맥측벽형동맥류모형。동맥류모형제작성공후2주행가강해미합금복막지가혹Willis복막지가식입술。지가식입후3、6화12개월행혈관조영검사，평개지가식입후동맥류적정황급재류측경총동맥통창정。지가식입후2주급1、2、4、6、9、12개월행목파검사，평개미합금지가적가강해정황。결과20지실험토좌측경총동맥균순리피결찰。결찰1개월후MRA검사시17지토경총동맥증조，이쌍측추동맥증조불명현혹무증조，우측경총동맥동맥류모형균건모성공。9개동맥류성공식입미합금복막지가，8개동맥류성공식입Willis복막지가。지가식입후즉각조영시소유동맥류강폐새，우경총동맥통창。술후3개월복사혈관조영，9개식입미합금복막지가적동맥류강완전폐새，차우경총동맥통창；8개식입Willis복막지가적동맥류강완전폐새，기중7지토우경총동맥통창，1지토우경총동맥폐새。술후6、12개월복사，16지토측벽동맥류소실，우경총동맥통창。목파현시미합금지가식입후수시간적연장이축보강해，이Willis지가잉보지원유적결구화형상。결론가강해미합금복막지가치료토경총동맥측벽형동맥류구유가행성。
Objective To discuss the feasibility of biodegradable covered magnesium alloys stent for a rabbit model of lateral aneurysm in the common carotid artery (CCA). Methods The left CCA was ligated in 20 conventional New Zealand rabbits. MRA of the neck was performed 1 month after ligation. The rabbits with thickening of the right CCA and non-or slight thickening of the bilateral vertebral arteries were selected for lateral aneurysm model making. The venous pouch and the right CCA wall by discontinuous extroversion sutures, to form a lateral aneurysm model. The biodegradable covered magnesium alloys stents or Willis covered stents were inserted two weeks after model making. Angiography was performed prior to the procedure, 3, 6 and 12 months after stent implantation to evaluate the disappearance of the aneurysms and patency of the right CCA. The degradation behaviour is invastagated with molybdenum target 2 weeks, 1, 2, 4, 6,9 and 12 months after stent placement. Results The left CCAs were successful ligated in all rabbits. MRA 1 month after ligation showed thickening of the right CCA and non-thickening of the bilateral vertebral arteries in 17 of 20 rabbits. In these animals, the CCA lateral aneurysm model was deemed successful, and biodegradable covered magnesium alloys stents and Willis covered stents were implanted in 9 and 8 aneurysms, respectively. DSA after biodegradable covered magnesium alloys stent placement displayed disappearance of the aneurysms and patency of the CCA in all 9 rabbits during follow-ups. DSA 3 months after Willis stent placement displayed patency of the CCA in 7 rabbits and occlusion of the artery in one. No occlusion of the right CCA was observed on angiography at 6 and 12 months. The degradation of the biodegradable covered magnesium alloys stent was investigated with molybdenum target during follow-ups, and no changes was observed in Willis covered stent. Conclusion Biodegradable covered magnesium alloys stent is a feasible approach for the treatment of a lateral aneurysm in the right CCA.