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首页> 外文期刊>Neurosurgical review. >Recurrence of endovascularly and microsurgically treated intracranial aneurysmsreview of the putative role of aneurysm wall biology
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Recurrence of endovascularly and microsurgically treated intracranial aneurysmsreview of the putative role of aneurysm wall biology

机译：血管内和显微外科治疗的颅内动脉瘤颅内动脉瘤的复发性脑腹墙体生物学推定作用

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Although endovascular therapy has been proven safe and has become in many centers the primary method of treatment for intracranial aneurysms, the long-term durability of endovascular embolization remains a concern; at least for some aneurysms despite initial good result. While healing after clipping relies on mechanical occlusion, restoration after endovascular occlusion mainly requires the induction of a biological response. Healing after embolization depends on the growth of new tissue over the thrombus formed by the embolization material, or alternatively, on the organization of thrombus into fibrous tissue. This review highlights the fundamental importance of aneurysm wall biology on the healing process and long-term occlusion after intracranial aneurysm (IA) treatment. It seems likely that the effect of luminal thrombus on the IA wall, as well as the IA wall condition at the time of thrombosis, determine if thrombus organizes into scar tissue (neointima formation by infiltration of cells originating from the IA wall) or if the wall undergoes continuous remodeling, which is primarily destructive (loss of mural cells). In the latter, intraluminal thrombus organization fails and the impaired healing increases the chance of recurrence. Mechanisms underlying IA reopening, the influence of intraluminal thrombosis on the IA wall, and clinical implications of the IA wall condition are discussed in detail, along with how knowledge of IA wall biology can offer new solutions for IA treatment and affect the patient selection for and follow-up after endovascular treatment.
机译：虽然血管内治疗已被证明是安全的，并且已成为许多中心的颅内动脉瘤治疗的主要方法，但血管内栓塞的长期耐久性仍然是一个问题;尽管有初始良好的结果，至少对于某些动脉瘤。虽然在剪切后愈合依赖机械闭塞后，血管内闭塞后的恢复主要需要诱导生物反应。栓塞后愈合取决于通过栓塞材料形成的血栓形成的新组织的生长，或者在血栓组织成纤维组织中。本综述突出了动脉瘤墙体生物学对颅内动脉瘤（IA）治疗后愈合过程和长期闭塞的基本重要性。似乎腔血栓对IA壁的影响，以及血栓形成时的IA壁状况，确定血栓是否组织成瘢痕组织（通过侵入来自IA墙的细胞的新内膜形成）或者墙壁经历连续重塑，主要是破坏性的（壁画细胞的丧失）。在后者中，腔内血栓组织失败，愈合受损增加了复发的机会。 IA重新开放的机制，详细讨论了IA壁上的IA壁的影响，以及IA壁状况的临床意义，以及如何了解IA壁生物学的知识可以为IA治疗提供新的解决方案，并影响患者选择血管内治疗后的随访。

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