PDF(Pubmed)
Abstract：
BACKGROUND: Neurovascular compression syndromes (NVCS), encompassing conditions such as trigeminal neuralgia, hemifacial spasm, and glossopharyngeal neuralgia, significantly impair patient quality of life through abnormal vascular compression and micro-pulsation of vasculature on cranial nerves at the Obersteiner-Redlich zone. The modulation of pulsatile flow dynamics via endovascular stents presents a novel research frontier for alleviating these syndromes.
OBJECTIVE: The primary aim of this investigation was to delineate the impact of various endovascular stents on pulsatile flow within an in vitro model of a blood vessel, thereby elucidating their potential applicability in the therapeutic management of NVCS.
METHODS: A simple in vitro analog of a posterior circulation artery was developed, employing an intravenous pump to replicate cardiac-induced blood flow. Within this model, alterations in pulsatile flow were quantitatively assessed following the introduction of three categorically distinct endovascular stents, varying in size. This assessment was facilitated through the employment of both micro-Doppler and Doppler ultrasound methodologies.
RESULTS: The Pipeline 5x35 mm stent (Medtronic, Minneapolis, MN) demonstrated the most significant reductions in peak systolic velocity (Vmax) and pulsatility index (PI), PI especially over the stent, suggesting its potential for drastically altering blood flow dynamics. Similarly, Neuroform Atlas 4.5x30 mm and Neuroform Atlas 4x24 mm stents (Stryker, Kalamazoo, MI) also showed notable decreases in hemodynamic parameters, albeit to different extents. Statistical analysis confirmed that these changes were significantly different from the control (P < 0.0001 for PI and Vmax; P < 0.05 for inter-stent comparisons), except for proximal PI means, which did not significantly differ from the control (P = 0.2777).
CONCLUSIONS: These findings affirm the potential of endovascular stents to substantially modulate arterial pulsatility. The observed decrease in pulsatile flow resultant from endovascular stent application has the potential to attenuate ectopic nerve excitation, a hallmark of NVCS. Consequently, this research highlights the prospective utility of endovascular stents in developing minimally invasive therapeutic approaches for NVCS.
OBJECTIVE: The primary aim of this investigation was to delineate the impact of various endovascular stents on pulsatile flow within an in vitro model of a blood vessel, thereby elucidating their potential applicability in the therapeutic management of NVCS.
METHODS: A simple in vitro analog of a posterior circulation artery was developed, employing an intravenous pump to replicate cardiac-induced blood flow. Within this model, alterations in pulsatile flow were quantitatively assessed following the introduction of three categorically distinct endovascular stents, varying in size. This assessment was facilitated through the employment of both micro-Doppler and Doppler ultrasound methodologies.
RESULTS: The Pipeline 5x35 mm stent (Medtronic, Minneapolis, MN) demonstrated the most significant reductions in peak systolic velocity (Vmax) and pulsatility index (PI), PI especially over the stent, suggesting its potential for drastically altering blood flow dynamics. Similarly, Neuroform Atlas 4.5x30 mm and Neuroform Atlas 4x24 mm stents (Stryker, Kalamazoo, MI) also showed notable decreases in hemodynamic parameters, albeit to different extents. Statistical analysis confirmed that these changes were significantly different from the control (P < 0.0001 for PI and Vmax; P < 0.05 for inter-stent comparisons), except for proximal PI means, which did not significantly differ from the control (P = 0.2777).
CONCLUSIONS: These findings affirm the potential of endovascular stents to substantially modulate arterial pulsatility. The observed decrease in pulsatile flow resultant from endovascular stent application has the potential to attenuate ectopic nerve excitation, a hallmark of NVCS. Consequently, this research highlights the prospective utility of endovascular stents in developing minimally invasive therapeutic approaches for NVCS.
摘要：
背景：神经血管压迫综合征（NVCS），包括三叉神经痛等疾病，面肌痉挛,和舌咽神经痛，通过Obersteiner-Redlich区的颅神经异常血管压迫和血管微脉动，显着损害患者的生活质量。通过血管内支架调节脉动流动力学为缓解这些综合征提供了新的研究前沿。
目的：这项研究的主要目的是描述各种血管内支架对血管体外模型内脉动流的影响，从而阐明其在NVCS治疗管理中的潜在适用性。
方法：开发了后循环动脉的简单体外类似物，使用静脉泵复制心脏诱导的血流。在这个模型中,在引入三种完全不同的血管内支架后，对脉动血流的改变进行了定量评估。大小不同。通过采用微多普勒和多普勒超声方法来促进这种评估。
结果：管道5x35毫米支架(美敦力，明尼阿波利斯,MN)表现出最显着的收缩期峰值速度(Vmax)和搏动指数(PI)的降低，PI尤其是在支架上，表明它有可能大幅改变血流动力学.同样，NeuroformAtlas4.5x30mm和NeuroformAtlas4x24mm支架（Stryker，卡拉马祖,MI)也显示血液动力学参数显著下降，尽管程度不同。统计分析证实，这些变化与对照组有显著差异（PI和VmaxP<0.0001；支架间比较P<0.05），除了近端PI意味着，与对照组无显著差异(P=0.2777)。
结论：这些发现肯定了血管内支架显著调节动脉搏动的潜力。观察到的血管内支架应用导致的脉动血流减少有可能减弱异位神经兴奋，NVCS的标志。因此,这项研究强调了血管内支架在开发NVCS微创治疗方法中的前瞻性应用。
目的：这项研究的主要目的是描述各种血管内支架对血管体外模型内脉动流的影响，从而阐明其在NVCS治疗管理中的潜在适用性。
方法：开发了后循环动脉的简单体外类似物，使用静脉泵复制心脏诱导的血流。在这个模型中,在引入三种完全不同的血管内支架后，对脉动血流的改变进行了定量评估。大小不同。通过采用微多普勒和多普勒超声方法来促进这种评估。
结果：管道5x35毫米支架(美敦力，明尼阿波利斯,MN)表现出最显着的收缩期峰值速度(Vmax)和搏动指数(PI)的降低，PI尤其是在支架上，表明它有可能大幅改变血流动力学.同样，NeuroformAtlas4.5x30mm和NeuroformAtlas4x24mm支架（Stryker，卡拉马祖,MI)也显示血液动力学参数显著下降，尽管程度不同。统计分析证实，这些变化与对照组有显著差异（PI和VmaxP<0.0001；支架间比较P<0.05），除了近端PI意味着，与对照组无显著差异(P=0.2777)。
结论：这些发现肯定了血管内支架显著调节动脉搏动的潜力。观察到的血管内支架应用导致的脉动血流减少有可能减弱异位神经兴奋，NVCS的标志。因此,这项研究强调了血管内支架在开发NVCS微创治疗方法中的前瞻性应用。
