Damage effect of Solitaire stent on tunica intima during thrombectomy

Q4 Medicine

中国现代神经疾病杂志 Pub Date : 2017-11-25 DOI:10.3969/cjcnn.v17i11.1690

Zhi-tie Han, Xiu-li Wang, Hai Yuan, Xiao-dong Song

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Abstract

Objective To discuss the damage effect of Solitaire stent on tunica intima during thrombectomy, so as to evaluate the safety of thrombectomy. Methods Twelve healthy male New Zealand rabbits were randomly divided into 4 groups (3 rabbits in each group), including control group and 3 thrombectomy groups. Microcatheter was used instead of stent in control group. The other 3 groups underwent mimic thrombectomy for 1, 3 and 5 times in the same position, respectively. The procedure was performed at both sides of carotid artery of each rabbit. Immediately after operation, bilateral carotid arteries of each rabbit were removed, performed HE staining and examined the ultrastructure under microscope. Semi?quantitative analysis was used to evaluate the damage of carotid artery. Results During the model preparation, DSA showed the diameter of vascular wall was 2.10-2.90 mm, and there was no vascular spasm, bleeding, perforation or arterial dissection. Therefore, the model was successfully established. The difference of carotid artery damage among different groups was statistically significant ( F = 119.108, P = 0.000). Compared with control group, the carotid artery damage of 3 thrombectomy groups was more serious ( q = 3.136, P = 0.001; q = 7.463, P = 0.000; q = 10.682, P = 0.000). The carotid artery damage of the second and third thrombectomy group was more serious than the first group ( q = 3.330, P = 0.000; q = 8.160, P = 0.000). The carotid artery damage of the third thrombectomy group was more serious than the second group ( q = 4.830, P = 0.000). Optical microscope observation showed that with the increase of times of thrombectomy, carotid intimal injury was more extensive and intimal reaction was more severe. Scanning electron microscopy showed that with the increase of times of thrombectomy, the degree of carotid artery injury was increased. Conclusions Solitaire stent may injure tunica intima, and with the increase of times of thrombectomy, the damage to vascular wall will increase. DOI: 10.3969/j.issn.1672-6731.2017.11.008

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Solitaire支架在血栓切除术中对内膜的损伤作用

目的探讨接龙支架在取栓过程中对血管内膜的损伤作用，评价取栓的安全性。方法12只健康雄性新西兰兔随机分为4组(每组3只)，分别为对照组和取栓组。对照组采用微导管代替支架。其余3组在同一体位分别进行1、3、5次模拟取栓。手术在每只兔的颈动脉两侧进行。术后即刻取各组双侧颈动脉，行HE染色，显微镜下观察其超微结构。半吗?定量分析颈动脉损伤程度。结果DSA示血管壁直径2.10 ~ 2.90 mm，未见血管痉挛、出血、穿孔及动脉剥离。因此，模型建立成功。各组患者颈动脉损伤程度差异有统计学意义(F = 119.108, P = 0.000)。与对照组相比，3个取栓组颈动脉损伤更严重(q = 3.136, P = 0.001;q = 7.463, P = 0.000;q = 10.682, P = 0.000)。第二组和第三组取栓组颈动脉损伤较第一组严重(q = 3.330, P = 0.000;q = 8.160, P = 0.000)。取栓第三组颈动脉损伤较取栓第二组更严重(q = 4.830, P = 0.000)。光学显微镜观察显示，随着取栓次数的增加，颈动脉内膜损伤范围更广，内膜反应更严重。扫描电镜显示，随着取栓次数的增加，颈动脉损伤程度增加。结论接龙支架可损伤血管内膜，且随着取栓次数的增加，对血管壁的损伤也会增加。DOI: 10.3969 / j.issn.1672-6731.2017.11.008

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