OBJECTIVEElectrolytic detachable coils (EDC) have been the main embolic materials for intracranial aneurysms. Liquid aneurysmal embolic materials represented by cellulose acetate polymer (CAP) are still in controversy. In this research, the embolization results and pathological reactions after embolization of canine aneurysmal models with EDC or CAP were observed and compared.

METHODSThe canine aneurysmal models constructed by anastomosis of venous pouches were randomly grouped. The aneurysms were respectively occluded with CAP and electrolytic detachable coils that was named by Wu electrolytic detachable coil (WEDC) and made by us. Angiogram follow-ups were performed at 24-hour, 2-week, and 2-month after embolization. The occluded aneurysms were dissected in each stage for light microscopic, electron microscopic, and histochemical research.

RESULTSThe effect of embolization was significantly better with WEDC than that with CAP (chi2 = 5. 56, P < 0.05). Post-embolized complications such as aneurysm rupture and stenosis of parent arteries could only be found in CAP group. Pathological research showed that CAP mass could packed the aneurysms more densely than coils. Acute chemical damage of aneurysmal wall and inflammatory cell infiltration was prominently found in early stage after CAP-embolization. Organization of thrombus inside aneurysms and formation of endothelial tissue over the orifices of aneurysmal necks could be found in both groups 2 months after embolization. But parts of coils might be exposed outside endothelial layer.

CONCLUSIONSEDC are still the most safe, efficient, and reliable instruments to embolize aneurysm. CAP should be improved further to solve the problem of strong chemical corrosion and difficulty in control before it is widely used.

Animals ; Biocompatible Materials ; Cellulose ; analogs & derivatives ; Dogs ; Embolization, Therapeutic ; instrumentation ; methods ; Female ; Follow-Up Studies ; Intracranial Aneurysm ; therapy ; Male ; Random Allocation ; Tungsten

BACKGROUNDAn ideal aneurysm model of cerebral aneurysm is of great importance for studying the pathogenesis of the lesion and testing new techniques for diagnosis and treatment. Several models have been created in rabbits and are now widely used in experimental studies; however, every model has certain intrinsic limitations. Here we report the development of a novel saccular aneurysm model in rabbits using an arterial pouch that is subject to in vitro pre-digestion with combined elastase and collagenase.

METHODSA segment of right common carotid artery (CCA) was dissected out and treated with elastase (60 U/ml, 20 min) followed by type I collagenase (1 mg/ml, 15 min) in vitro. The graft was anastomosed to an arterial arch built with the left CCA and the remaining right CCA, while the other end of the graft was ligated. The dimension and tissue structure of the pouch were analysed immediately, 2 or 8 weeks after operation.

FINDINGSTen terminal aneurysms were produced. The gross morphology of the aneurysm resembles the human cerebral terminal aneurysms. We have observed the following pathological changes: (1) growth of the aneurysm (mean diameter increased from (2.0+/-0.1) to (3.2+/-0.3) mm at 2 weeks, P<0.001, n=7-10); (2) thinning of the aneurysmal wall (the mean wall thickness decreased to 44% at 2 weeks), which was accompanied by significant losses of elastic fibres, collagen and the cellular component; and (3) spontaneous rupture (3 out of 9, one aneurysm ruptured 24 h after operation with the other two at 2 and 4 weeks respectively).

CONCLUSIONThis rabbit arterial pouch model mimics human cerebral aneurysms in relation to morphology and histology. In particular, this model exhibited an increased tendency of spontaneous rupture.

Animals ; Carotid Artery, Common ; drug effects ; pathology ; physiopathology ; Collagenases ; Disease Models, Animal ; In Vitro Techniques ; Intracranial Aneurysm ; chemically induced ; pathology ; physiopathology ; Pancreatic Elastase ; Rabbits

Objective To induce islet allograft long-term survival through cotransplantation of islet cells with sertoli cells. Methods Testicular sertoli cells were prepared by digestion with collagenase, trypsin and DNase, and were cultured for 48 hours. Collagenase digested and Ficoll purified donor (Wistar rat) islets were cotransplanted with allogeneic sertoli cells in the absence of systemic immunosuppression. Terminal leoxynucleotidyl transferase-mediated X-dUTP nick-end labeling (TUNEL) was used to label apoptosis of lymphocytes surrounding the islet graft. Results Cotransplantation of islets and 1 × 107 sertoli cells reversed the diabetic state for more than 60 days in 100% (6/6) of the chemically diabetic Sprague Dawley rats. Grafts consisting of islets alone or islets plus 1 × 105 sertoli cells survived only for 5 - 6 days. Apoptosis of lymphocytes surrounding the islets was quite clear. Conclusion Cotransplantation of islets with FasL+ sertoli cells induces local immune privilege and allows long-term graft survival without systemic immunosuppression.

OBJECTIVETo primarily embolize intracranial aneurysms with new-developed mechanically detachable coils, which is called Detachable Coil System (DCS).

METHODSFive intracranial aneurysms were embolized with DCS, in which 2 were giant aneurysms. DCS with J coils were initially used to make baskets in giant aneurysms, and then other kinds of coils were utilized to pact the aneurysmal cavity. Whereas, spiral coils were mostly used in smaller aneurysms. Coils of DCS were detached by rotating the delivering wire after the coils were satisfactorily positioned in aneurysms.

RESULTSTwo of the 5 cases were totally occluded with DCS. Two was sub-totally embolized. Pushing, withdrawal, and adjusting of DCS were safe and efficient. Detachment of DCS was fast. In one case of wide-necked giant aneurysm, coils could not stay inside the aneurysm, which was treated by occlusion of the parent artery.

CONCLUSIONSDCS is a new addition to the interventional radiologist's armamentarium. Detachment is faster. J coils are suitable for giant aneurysms for its unique way of coiling. But more evaluation depends on accumulation of the clinical usage.

Embolization, Therapeutic ; methods ; Female ; Humans ; Intracranial Aneurysm ; therapy ; Male ; Middle Aged

OBJECTIVETo evaluate the efficacy of treating severe and chronic vertebral compressive fractures in the elderly with percutaneous vertebroplasty.

METHODSSixteen patients who suffered from severe back pain and whose daily living was badly affected were retrospectively reviewed. The average age was 72.5 years, the average disease history was 19 months, and the average compressive rate of the affected vertebral bodies was 74.1%.

RESULTSNineteen affected compressive vertebral bodies in 16 cases were treated with percutaneous vertebroplasty. All the procedures were successful without any complication. After 3.5-7 ml of cement was injected into the lesions, complete relief was achieved in 3 cases, remarkable relief was achieved in 11 cases, and improvement was observed in 2 cases. The scores of 6-point Behavioral Rating Scale and Activity of Daily Living (ADL) declined significantly after the treatment (P < 0.001).

CONCLUSIONPercutaneous vertebroplasty can significantly improve the symptoms and quality of life in the elderly patients with severe and chronic vertebral compressive fractures.

Activities of Daily Living ; Aged ; Aged, 80 and over ; Back Pain ; surgery ; Bone Cements ; therapeutic use ; Female ; Fractures, Spontaneous ; etiology ; surgery ; Humans ; Lumbar Vertebrae ; surgery ; Male ; Orthopedic Procedures ; methods ; Osteoporosis ; complications ; Quality of Life ; Retrospective Studies ; Spinal Fractures ; etiology ; surgery ; Thoracic Vertebrae ; surgery

OBJECTIVETo investigate the efficacy of percutaneous vertebroplasty in the treatment of vertebral hemangioma.

METHODSSeven patients with vertebral hemangiomas were treated by percutaneous vertebroplasty, including one case of cervical, three cases of thoracic, and three cases of lumbar hemangiomas. The average score of the 6-point behavioral pain rating scale was 2.67 +/- 0.41, and the average score of ambulation was 2.83 +/- 0.33. Guilty vertebral bodies were orientated with fluoroscopy. The procedures were performed under local anesthesia. The image features were also analyzed. Unipedicular or bipedicular approaches were used in 6 cases of thoracic and lumbar hemangiomas. The cervical anterior-lateral approach was adopted in one case of cervical hemangioma. 4-7 ml of 15%-20% bone cement was mixed and injected into the vertebral body to form a cast in the lesions. Re-examination of clinical symptoms, plain film, and CT were made for 1, 3, and 9 months of post-procedure follow-up.

RESULTSGood results were achieved in all the seven cases. Pain was completely relieved in 5 cases and partially relieved in 2 cases. Symptom was also recovered in 2 patients with radiculopathy. No recurrence was found after 1-9 months of postoperative follow-up.

CONCLUSIONTreatment of vertebral hemangioma with percutaneous vertebroplasty is safe and effective with minimal invasion.

Adult ; Cervical Vertebrae ; surgery ; Female ; Follow-Up Studies ; Hemangioma ; surgery ; Humans ; Lumbar Vertebrae ; surgery ; Male ; Middle Aged ; Orthopedic Procedures ; methods ; Pain Measurement ; Spinal Neoplasms ; surgery ; Thoracic Vertebrae ; surgery