Dual intervention for traumatic carotid aneurysm within foreign body: Animal experimentation / 中国介入影像与治疗学

ABSTRACT

Objective: To investigate the technological feasibility and effect of a new dual intervention method for traumatic carotid aneurysm penetrated by retained foreign body (FB) through animal experiment. Methods: Models of traumatic carotid aneurysm within FB retention were established by surgical vein grafting to the right carotid artery within broken needle penetration (experiment group) in 5 healthy beagle dogs aged about 2 years old. And the left necks of the dogs were modeled by broken needle embedding into soft tissue nearby carotid artery (control group). In experiment group, the degradable covered-stents were directly placed into the parent artery though 7F vascular sheath for plugging aneurysm, and fluoroscopy-guided FB removing using forceps were carried out simultaneously. In control group, it was just performed percutaneous trans-soft-tissue FB removing with forceps under the guidance of fluoroscopic carotid artery guidewire-positioning. DSA was used to evaluate the effect of interventional therapy. Furthermore, CTA or MRA was used for following-up. Results: The technical successful rate of direct trans-sheath stent implantation in experiment group was 100%(5/5), but the rate of aneurysm bleeding after interventional FB retrieval was also 100%(5/5). All hemorrhage symptoms were cured after degradable covered-stents releasing. No aneurysm recurrence occurred 3 months after intervention, but mild to moderate stenosis of local carotid were found in all models in experiment group. In control group, the successful rate of FB retrieval was 100%(5/5) without carotid hemorrhage or stenosis. Conclusion: As an one-stop method, degradable covered-stent-assisted dual intervention can be used to remove FB and occlude traumatic carotid aneurysm of neck in dog models simultaneously. Direct trans-sheath implantation may be an alternative method for stent placement in animal study.