Cov txheej txheem Neurointerventional tau dhau los ua ib qho tseem ceeb hauv kev tswj hwm ntawm ntau yam kab mob intracranial xws li arterial aneurysms mus rau arteriovenous malformations. Ntawm cov kev txiav txim siab tseem ceeb uas tus kws kho mob neurointerventional yuav tsum tau ua yog xaiv tus neeg sawv cev tsim nyog embolic. Ob ntawm cov neeg siv ntau tshaj plaws yog Ethyl-Vinyl Alcohol Liquid Embolic Agents (EVOH) thiab N-Butyl Cyanoacrylate (NBCA). Ob tus neeg sawv cev no muaj lawv qhov zoo thiab kev txwv. Kab lus no yog tsom los sib piv EVOH thiab NBCA thiab txiav txim siab seb qhov twg yog qhov kev xaiv zoo dua rau cov txheej txheem neurointerventional.
EVOH Liquid Embolic Agents yog hydrophobic, biocompatible, non-adhesive, thiab maj mam degradable copolymer ntawm ethylene-vinyl cawv uas zoo occludes cov hlab ntsha ntws ntawm cov hlab ntsha. Kev siv EVOH cov neeg ua haujlwm txo qhov kev pheej hmoo ntawm qhov tsis yog lub hom phiaj embolization, thiab nws muab kev tswj kom zoo dua ntawm qhov ntom thiab qhov nyiaj ntawm embolization. Lub sijhawm polymerization ntawm EVOH yog ntev dua, uas xav tau ceev faj thaum txhaj cov khoom vim tsis xav tau kev tsiv teb tsaws ntawm tus neeg sawv cev embolic tuaj yeem tshwm sim. Cov kauj ruam ntxiv yog tsim nyog los ua kom cov concentration ntawm tus neeg sawv cev embolic thaum tswj kom zoo viscosity. Anatomical thiab txheej txheem kev txawj ntse thiab kev paub yog qhov tseem ceeb thaum siv EVOH embolic agents. EVOH cov neeg ua haujlwm tau txais kev pom zoo los ntawm FDA los kho cov kab mob intracranial vascular, nrog rau pulmonary arteriovenous malformations.
N-Butyl Cyanoacrylate (NBCA) yog ib tug ceev thiab muaj zog kua embolic tus neeg saib xyuas uas sai polymerizes ntawm kev sib cuag nrog cov ntshav. NBCA yog ib qho nplaum nplaum, uas ua rau nws muaj txiaj ntsig zoo hauv kev tsom mus rau cov hlab ntsha me thiab tortuous, thiab txo qis rov los ntshav, tshwj xeeb tshaj yog nyob rau hauv cov xwm txheej ntawm arteriovenous malformations thiab dural arteriovenous fistulas. NBCA polymerization lub sij hawm luv luv, uas txwv lub sij hawm tus interventionalist yuav tsum reposition lub catheter thiab txhaj tshuaj ntawm tus neeg sawv cev embolic. Tsis tas li ntawd, NBCA yog qhov khov heev, xav tau cov txheej txheem sib xyaw tshwj xeeb thiab cov txheej txheem ntsuas kub kom tswj tau nws qhov tsim nyog sib xws thaum txo qhov kev pheej hmoo ntawm cov ntaub so ntswg uas nyob ib sab thiab tsis yog lub hom phiaj embolization. Scov kev kawm tau pom tias EVOH muab cov txiaj ntsig mus sij hawm ntev hauv kev cuam tshuam ntawm cov hlab ntsha loj thiab dysplastic thaum txo qis kev pheej hmoo ntawm kev tsis sib haum xeeb.
Hais txog kev nyab xeeb ntawm cov txheej txheem, ob qho tib si EVOH thiab NBCA muaj qhov pheej hmoo tsawg ntawm embolization. EVOH, txawm li cas los xij, nthuav tawm qhov tseem ceeb ntawm hyperdense cerebral edema mus txog 14 hnub tom qab nws txhaj tshuaj, uas yuav ua rau qeeb intracranial hemorrhage. Hais txog NBCA, nws muaj kev pheej hmoo ntau dua ntawm cov nqaij mos necrosis thiab tsis yog lub hom phiaj embolization. Kev siv NBCA yuav tsum tau ceev faj ntxiv thaum tswj hwm hauv cheeb tsam peddicular, vim tias muaj peev xwm tsis xav tau tsiv teb tsaws chaw mus rau tus txha caj qaum tuaj yeem tshwm sim.
Hauv kev xaus, ob tus neeg sawv cev muaj lawv cov txiaj ntsig thiab kev txwv. EVOH muaj lub sijhawm ua polymerization ntev dua thiab yuav tsum tau ua tib zoo tuav, uas tej zaum yuav nyuaj rau qee tus kws kho mob. NBCA, ntawm qhov tod tes, muaj lub sijhawm luv luv polymerization, tab sis nws tuaj yeem nyuaj los tswj tus nqi ntws, tshwj xeeb tshaj yog nyob rau hauv cov hlab ntsha tortuous. Xav txog lub luag haujlwm tseem ceeb ntawm sab nraud, xws li hom txheej txheem, tus neeg mob yam xwm txheej, cov txiaj ntsig, thiab kev txwv ntawm ob tus neeg sawv cev, kev tshuaj xyuas kom zoo, thiab tus kheej txoj hauv kev yuav pab cov kws kho mob xaiv tus neeg saib xyuas embolic zoo rau lawv cov neeg mob.