ABSTRACT
Objective To investigate the safety and short-term efficacy for evaluation of the low-profile visualized intraluminal support device (LVIS stents )compression and lantern release shapes for the treatment of wide-necked intracranial aneurysms. Methods From December 2014 to October 2015,15 patients with intracranial wide-neck aneurysm (16 aneurysms)received LVIS stent treatment, whose stent shapes had shortening changes were analyzed retrospectively. Thecompression mode refers to the length of LVIS stent to be shorter for more than 5 mm than the label release value by operation. Thelantern mode refers to the widened diameter of LVIS stent at the neck of aneurysm. The metal coverage rate in the posterior communicating segment of internal carotid artery after stent compression was calculated, and its safety and efficacy were assessed immediately after procedure and at 3 months after procedure. Results (1 )Using LVIS stent-assisted treatment,16 wide-necked aneurysms were treated,including 8 posterior communicating aneurysms,6 ophthalmic aneurysms,one anterior choroidal artery aneurysm and one M2 bifurcation fusiform aneurysm. The aneurysm neck was 1. 8 to 8. 0 mm (mean 3. 9 ± 1. 7 mm). A total of 15 LVIS stents were implanted (one patient with 2 aneurysms were treated with 1 stent). All the stents were released by using compression mode,and 4 of the patients (4 stents)also used the lantern mode at the same time. (2 ) After LVIS stenting,the Raymond grade Ⅰ embolization was in 10 aneurysms (62.5%),the covered branch arteries were patent immediately after procedure. (3)No perioperative technology-related hemorrhagic and ischemic complications occurred. The success rate of stent implantation was 100%(15/15). (4)The metal coverage rate after stent compression in the internal carotid artery posterior communicating segment was 30. 3%-38. 5%(mean 35. 0 ± 2. 8%). (5)After LVIS stent implantation,15 patients were followed up by whole brain DSA for 3 to 5 months (mean 3. 2 ± 0. 5), 14 aneurysms were cured on imaging (Raymond gradeⅠ),and no aneurysm recurred. All branch arteries covered by the stents did not have vascular occlusion. There was no in-stent restenosis or parent artery occlusion. The total disability rate was 6. 7%(1/15),and no patient died. Conclusions LVIS stents can increase aneurysm neck metal coverage rate and short-term cure rate throughcompression andlantern modes,while does not affect the covered branches. Choosing the appropriate cases for thelanternmode may be beneficial to the short-term protection of the vascular branches at the aneurysm necks.
ABSTRACT
Objective To investigate the synthesis, in vivo biodistribution of 99Tcm-HYNIC-PEG4-E[PEG4-c (RGDfk)] 2 (99 Tcm-Galacto-RGD2), and its potential usage for targeted imaging of mice orthotopic glioma.Methods 99Tcm-Galacto-RGD2 was synthesized straightforward and its radiochemical purity and stability and distribution in mice were analyzed.MicroSPECT-CT imaging was done in a mice orthotopic glioma model, which had been set up with U87MG cells, after administration of 99Tcm-Galacto-RGD2.Region of interest (ROI) of glioma was drawn on SPECT-CT section images to quantify tumor uptake (％ ID/cm3).Glioma was harvested for pathological examination.Linear-regression was used to analyze the relationship between integrin αvβ3 and tumor uptake (％ID/cm3).Results The radiochemical purity of 99Tcm-Galacto-RGD2 was (97.7 ±0.8)％ and stable in vitro.Hynic-Galacto-RGD2 could specifically bind to integrin αv β3 of tumor cells with a IC50 of (18 ± 3) nmol/L.After tail vein injection, 99Tcm-Galacto-RGD2 was rapidly discharged from the blood, liver, kidneys and had a relative low concentration in normal brain tissue.MicroSPECT-CT imaging demonstrated that, after 60 min of injection, this drug was well uptaken by glioma tumor than that after 30 min (t =7.13 ,P ＜0.05), and the tumor to normal brain tissue (T/B) uptake ratio of 99Tcm-Galacto-RGD2 was 13.92± 3.43.Injection of HYNICGalacto-RGD2 2 min prior to 99Tcm-Galacto-RGD2 injection extensively reduced the uptake of radioactive drug in tumor tissue (t =11.36, P ＜ 0.05).Bland-Altman analysis showed that tumor volume based on SPECT-CT imaging measurement had almost same value with the tumor reference volume (95％ CI =-11.94％-11.92％).In addition, the tumor uptake of 99Tcm-Galacto-RGD2 and cellular integrin αvβ3 expression level had a linear relationship (R2 =0.896).Conclusions Stable 99Tcm-Galacto-RGD2 can be synthesized easily and is applicable for microSPECT-CT imaging analysis of orthotopic glioma in mice together with the evaluation of integrin αvβ3 level in tumor.