IntroductionEndothelial cells (ECs) continuously line the cerebrovasculature. Molecular aberrations in the ECs are hallmarks and contributory factors to the development of cerebrovascular diseases, including intracranial aneurysms and arteriovenous malformations (AVMs). Endovascular biopsy has been introduced as a method to harvest ECs and obtain relevant biologic information. We aimed to summarize the literature on endovascular biopsy in neurointerventional surgery.MethodsWe conducted a comprehensive literature search in multiple databases, identifying eligible studies focusing on neurosurgical applications of endovascular biopsy. The systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. The relevant information was collected, including study characteristics, biopsy techniques, and key findings.ResultsNine studies met the inclusion criteria and were included. The studies involved the collection of ECs using various endovascular devices including coils, guide wires, different stents, and forceps. Endothelial-enrichment techniques, such fluorescence-activated cell sorting (FACS), collected ECs and facilitated downstream applications of bulk or single-cell RNA sequencing (scRNAseq). The studies provided insights into gene expression profiles and identified potential biomarkers associated with intracranial aneurysms. However, challenges were observed in obtaining an adequate number of ECs and identifying consistent biomarkers.ConclusionEndovascular biopsy of endothelial cells (ECs) in cerebrovascular pathologies shows promise for gene expression profiling. However, many studies have been limited in sample size and underpowered to identify “signature genes” for aneurysm growth or rupture. Advancements in minimally invasive biopsy methods have potential to facilitate applications of precision medicine in the treatment of cerebrovascular disorders.

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神经介入手术中的血管内活检：系统评价

简介内皮细胞 (EC) 连续排列在脑血管系统中。 EC 中的分子畸变是脑血管疾病（包括颅内动脉瘤和动静脉畸形 (AVM)）发展的标志和促成因素。血管内活检已被引入作为收获 EC 并获取相关生物学信息的方法。我们的目的是总结神经介入手术中血管内活检的文献。方法我们在多个数据库中进行了全面的文献检索，确定了关注血管内活检在神经外科应用的合格研究。系统评价遵循系统评价和荟萃分析的首选报告项目 (PRISMA) 声明。收集了相关信息，包括研究特征、活检技术和主要发现。结果 9 项研究符合纳入标准并被纳入。这些研究涉及使用各种血管内装置（包括线圈、导丝、不同的支架和镊子）收集 EC。内皮富集技术，例如荧光激活细胞分选 (FACS)，收集 ECs 并促进批量或单细胞 RNA 测序 (scRNAseq) 的下游应用。这些研究提供了对基因表达谱的深入了解，并确定了与颅内动脉瘤相关的潜在生物标志物。然而，在获得足够数量的 EC 和识别一致的生物标志物方面存在挑战。 结论 脑血管病理中内皮细胞 (EC) 的血管内活检显示出基因表达谱分析的前景。然而，许多研究的样本量有限，无法确定动脉瘤生长或破裂的“特征基因”。微创活检方法的进步有可能促进精准医学在脑血管疾病治疗中的应用。