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目的 探讨新型栓塞材料聚氨酯（PA）栓塞脑动静脉畸形（AVM）的可行性,评价其引起的病理改变。方法 体外实验测定PA/DMSO的物理性质如沉淀时间、粘质度和密度等。体内实验以猪自然存在的颅底血管网（RMB）为AVM的模型。PA/DMSO溶液栓塞后不同时期行脑血管造影复查,并获取标本行光镜检查。结果 在20℃和37℃条件下,实验所用PA/DMRO溶液的沉淀时间分别为（13.50±0.150）s和（13.48±0.143）s（P>0.05）,温度对其无影响。PA栓塞后动物无不良临床反应或死亡。通过微导管注射PA/DMSO无困难,未发生微导管粘附于血管壁的情况,PA在RMB内的弥散和铸型良好。造影复查未见血管再通。主要病理改变为血管内弹力层的断裂或消失以及炎性反应。结论 PA作为非粘附性液体栓塞材料可达到永久栓塞的目的。其病理反应不引起不良症状,临床上可以接受。为较理想的AVM的栓塞材料。
Objective To investigate the feasibility of embolization of cerebral arteriovenous malformation (AVM) by a new embolic material polyurethane (PA) and evaluate the pathological changes caused by it. Methods In vitro experiments were performed to determine the physical properties of PA / DMSO such as settling time, viscosity and density. In vivo experiments with pigs naturally found in the skull base vascular network (RMB) as AVM model. Cerebral angiography was performed in different periods after PA / DMSO solution embolization, and the specimens were obtained under light microscope. Results Under the conditions of 20 ℃ and 37 ℃, the precipitation time of PA / DMRO solution was (13.50 ± 0.150) s and (13.48 ± 0.143) s respectively (P> 0.05), and the temperature had no effect on it. After embolism, the animal had no adverse clinical response or died. The injection of PA / DMSO through the microcatheter was not difficult and there was no microcatheter adhesion to the vessel wall. The dispersion of PA in the RMB and the mold were good. Angiography review no recanalization. The main pathological changes are the breakdown or disappearance of the intravascular elastic layer and the inflammatory response. Conclusion PA as a non-adhesive liquid embolic material can achieve the purpose of permanent embolization. The pathological response does not cause adverse symptoms, clinically acceptable. For the more ideal AVM embolic material.