Vascurar reconstruction by the endovascular vein-loaded stent
| Project/Area Number |
09671419
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| Research Category |
Grant-in-Aid for Scientific Research (C)
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| Allocation Type | Single-year Grants |
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| Section | 一般 |
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| Research Field |
Cerebral neurosurgery
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| Research Institution | Nagoya University |
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Principal Investigator |
NEGORO Makoto School of medicine, Nagoya University Assistant, 医学部, 助手 (90115618)
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| Co-Investigator(Kenkyū-buntansha) |
ISHIGUCHI Tsuneo School of medicine, Associate Professor, 医学部, 助教授 (70115525)
宮地 茂 名古屋大学, 医学部, 助手 (00293697)
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| Project Period (FY) |
1997 – 1998
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| Project Status |
Completed (Fiscal Year 1998)
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| Budget Amount *help |
¥3,500,000 (Direct Cost: ¥3,500,000)
Fiscal Year 1998: ¥1,100,000 (Direct Cost: ¥1,100,000)
Fiscal Year 1997: ¥2,400,000 (Direct Cost: ¥2,400,000)
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| Keywords | Aneurysm / experimental Stent / vein-loaded / Vein graft / autologous / 血行再建 / 自家静脈 / バルーン |
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| Research Abstract |
Wide-necked aneurysms and fusiform aneurysms are still difficult to cure, despite recent advances in microsurgery and endovascular surgery. An endovascular vein graft with stenting seemed to be the optimal method to immediately close the aneurysm orifice without interrupting the parent arterial flow.
Furthermore, because of the autologous graft it may possess superior adaptability to the vessel wall and be more biocompatible than other artificial covered stents.
In this study we have devised technical mathods to simplify the complicated deployment of stents.
The vein-loaded stent, made by connecting the autologous vein graft to the yein-carrier stent, was implanted in the commom carotid artery to scal the aneurysm's orifice, after which two booster stents were deployed. The distal stent was placed to fix the distal end of the vein graft, and the proximal stent was placed at the proximal venous portion of the bein-loaded stent to reinforce its proximal end. In this manner an intra-arterial bypass was established across the aneurysm. Of 13 aneurysms seven were completely occlueded, preserving the parent artery. The remaining six procedures resulted in parent artery occlusion because of failures in stent deployment. Angiograms performed in within 1 week six successfully treated dogs revealed the parent artery to be patent in four but thrombosed in two. Histological study of successful cases showed as smooth intima with slight endothelial hypertrophy and partially organised thrombus. The intraluminal features were also observed with a vascular endoscope at the time of treatment in four dogs and at the time of follow-up angiography in two. The appearances corresponded well to the macroscopic findings in the specimens. Our vein-loaded stent system offers complete closure of the orifice, which does not occur with conventional stent placement. The mathod is believed to show clinical promise for treating wide-necked aneurysms not curable by embolization of the sac.
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Report
(3 results)
Research Products
(5 results)
