| Long-term histological and scanning electron microscopy results of endovascular and operative treatments of experimentally induced aneurysms in the rabbit. | |
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MedLine Citation:
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PMID: 17038956 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: Treatment strategies of cerebral aneurysms include surgical clipping and endovascular therapies. To determine the long-term results of these therapeutic strategies, the vessel wall reaction close to the former aneurysm was studied according to the assumption that an intact endothelial layer over the former aneurysm neck constitutes complete vessel wall reconstruction and stable aneurysm obliteration. METHODS: Aneurysms were created in 40 rabbits by intraluminal elastase incubation of the common carotid artery. Five animals each were assigned to the following groups: untreated, porous stents, polyurethane covered stentgrafts, porous stents with subsequent coiling. Ten animals were treated with coils alone, 10 with clips. After 6 months, angiography, histology, and scanning electron microscopy was performed. RESULTS: Porous stents did not obliterate the aneurysm, whereas stentgrafts did; in-stent stenosis of up to 60% was present because of neointimal multilayer proliferation. After coiling, the aneurysm dome was occluded with fibrinous and collagenous material, whereas the aneurysm neck was not covered by an endothelial lining. Coil loops lay bare within the vessel, with fresh thrombus material on their surface. After clipping, a thin layer of endothelial lining bridging the two attached vessel walls was present, thereby completely obliterating the aneurysm and reconstructing the vessel wall. CONCLUSION: This study demonstrates complete and stable aneurysm obliteration with vessel wall reconstruction after clipping, a sufficient obliteration of the aneurysm dome using endovascular techniques, but a failed healing response of the aneurysm neck that might correlate to its associated higher risk of rebleed. Whether or not this is counterbalanced by the better immediate outcome after endovascular treatment remains a matter of debate. |
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Authors:
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Timo Krings; Claudia Busch; Bernd Sellhaus; Angela Y Drexler; Manfred Bovi; Benita Hermanns-Sachweh; Kira Scherer; Joachim M Gilsbach; Armin Thron; Franz J Hans |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Neurosurgery Volume: 59 ISSN: 1524-4040 ISO Abbreviation: Neurosurgery Publication Date: 2006 Oct |
Date Detail:
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Created Date: 2006-10-13 Completed Date: 2006-10-27 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 7802914 Medline TA: Neurosurgery Country: United States |
Other Details:
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Languages: eng Pagination: 911-23; discussion 923-4 Citation Subset: IM |
Affiliation:
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Department of Neuroradiology,University Hospital, University of Technology, Aachen, Germany. tkrings@izkf.rwth-aachen.de |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Animals Blood Vessel Prosthesis Carotid Artery Diseases / chemically induced, pathology*, physiopathology, therapy* Carotid Artery, Common / pathology*, radiography Cerebral Angiography Constriction, Pathologic / etiology Embolization, Therapeutic / adverse effects, instrumentation Endothelium, Vascular / pathology Intracranial Aneurysm / chemically induced, pathology*, physiopathology, therapy* Microscopy, Electron, Scanning Neurosurgical Procedures Pancreatic Elastase Postoperative Period Rabbits Stents / adverse effects Thrombosis / etiology Time Factors Wound Healing |
| Chemical | |
Reg. No./Substance:
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EC 3.4.21.36/Pancreatic Elastase |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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