RÉSUMÉ
Objective To evaluate the safety and efficacy of endovascular stent placement in the management of ruptured vertebral artery dissecting ancurysms. Methods A retrospective analysis was conducted in 9 patients with ruptured vertebral artery dissecting aneurysms treated in our department between July, 2004 and January, 2007 by means of endovascular stenting. Of these cases, 3 were treated with exclusive stent placement and 6 with stent-assisted coiling. Results Stent deployment and coil embolization were carried out successfully in all the cases. The vertebral arteries with stent placement remained patent after the surgery, and stent thrombosis or aneurysmal rupture occurred in none of the cases. During the follow-up for 4 to 39 months, no clinical evidence of rebleeding was found in these patients. Follow-up angiography was performed in 6 of the patients 3-18 months after the surgery, and two patients treated with stent-assisted coiling showed aneurysm recurrence or enlargement and underwent secondary internal trapping or proximal occlusion; two patients receiving endovascular stenting showed complete embolization of the anenrysm, and one patient showed partial embolization. Conclusion Endovascular stent placement is safe and effective for management of raptured vertebral artery dissecting aneurysms and allows the involved artery to remain patent after the surgery. Close follow-up is necessitated in these patients, and the long-term effect of this treatment remains to be further observed.
RÉSUMÉ
Objective To evaluate the effect of hyperbaric oxygen (HBO) treatment on the expression of nestin in a model of right middle cerebral artery occlusion (MCAO) in rabbits. Methods Seventy healthy rabbits were dividod into 3 groups: the rabbits in MCAO+HBO group(n=30) were treated with HBO immediately after MCAO, once a day, consecutively for 20 d; the rabbits in MCAO group (n=30) were not trcated with any therapy after MCAO; the control group (n=10) received the same operation as that of MCAO group except MCAO. Rabbit behaviors and volumes of infarction were observed, and the expression of nestin was measured by immunocytochernistry 10 and 20 d after MCAO. Results Behaviors' scores and volumes of infarction were better in MCAO+HBO group than the MCAO group (P<0.05). 10 d after MCAO, the number of nestin-immunoreactive cells of MCAO+HBO group and MCAO group was respectively 15.88±1.2 and 6.63±1.6; 20 d after MCAO, the number in MCAO+HBO group and MCAO group was respectively 20.03±1.6 and 6.82±0.8. The number of nestin-immunoreactive cells in MCAO+HBO group was significantly higher compared with that of MCAO group (P<0.05). Conclusion Early applications of HBO and repeated administration of HBO for 20 d can evidently improve the behaviors and infarct size and elevate the expression of nestin in rabbit models of MCAO.