Study On In Vitro Experiment Of Mechanism Of Endovascular Electrothrombosis With Microguidewire

ObjectiveAs a supplement for endovascular treatment of cerebrovascular diseases,intra-arterial electrothrombosis with microguidewire has been applied in the treatment of complicated intracranial aneurysms,such as blood blister-like aneurysms and micro-aneurysms of perforator,and achieved a significant therapeutic effect.But its mechanism is still unclear.We designed a vitro physical model of intracranial aneurysms aiming to clarify the mechanism of electrothrombosis with microguidewire in order to provide reference for clinical application in the future.MethodA standardized physical model of intracranial aneurysms was made by three-dimensional printing technique,and a micro-peristaltic pump was connected with a catheter in a constant temperature box to simulate pulsating blood flow followed by verification of the feasibility.Electrothrombosis with microguidewire was performed in the in vitro model that filled with anticoagulant arterial blood of experimental animals,and the differences of microstructure and thrombosis along time axis between different temperature,charge adsorption and thrombogenicity of electrolytic gas production were compared.The thrombosis efficiency and microstructure differences of different thrombosis formed by neck-clipping,coiling,microguidewire electrocoagulation and coil electrocoagulation after coiling in vitro aneurysm model were also compared.ResultsThe visualized aneurysm model made by three-dimensional printing technique simulates pulsating dynamic blood flow and has stable hemodynamic characteristics that closer to the physiological state of a human body.The thrombogenic effect of charge adsorption effect is exact,while the thrombogenic effect of temperature change and electrolytic gas production is not obvious.There are microstructural differences in the type of cell aggregation and fibrin content between the thrombus formed by electrothombosis and primary clipping and coiling at the same time,and the electrothrombosis with a coil has the highest efficiency of thrombosis compared that with a microguidewire,and its microstructure of the formed thrombus is also more stable.ConclusionThe charge adsorption effect plays a major role in the endovascular electrothrombosis with microguidewire,and the thrombosis is positively correlated with the duration of electrification.Compared with the thrombus formed physiologically,the thrombus induced by electrothrombosis is more stable and has a higher degree of organization,and the electrothrombosis with coil is more obvious than that with microguidewire.Increasing the electrified duration of bare metal coil is an effective method to improve the efficiency of thrombosis in aneurysmal sac.