中国组织工程研究

中国组织工程研究 ›› 2015, Vol. 19 ›› Issue (18): 2849-2855.doi: 10.3969/j.issn.2095-4344.2015.18.011

• 器官移植动物模型 organ transplantation and animal model • 上一篇    下一篇

建立椎动脉急性血栓栓塞犬模型：微球囊导管临时隔截取栓

韦文姜1，肖承江1，李立恒1，江桂华2   

  1. 广东省第二人民医院，1介入科，2影像科，广东省广州市  510317
  • 收稿日期:2015-02-16 出版日期:2015-04-30 发布日期:2015-04-30
  • 通讯作者: 肖承江，硕士，主任医师，广东省第二人民医院介入科，广东省广州市 510317
  • 作者简介:韦文姜，男，1986年生，广西壮族自治区人，壮族，2013年中山大学毕业，硕士，医师，主要从事介入放射学研究。
  • 基金资助:

    广东省高科技基金资助项目(2012B031800477)

Establishment of acute vertebral artery thrombosis models in dogs: micro-balloon catheter temporary isolation for embolectomy

Wei Wen-jiang1, Xiao Cheng-jiang1, Li Li-heng1, Jiang Gui-hua2   

  1. 1Interventional Department, 2Department of Imaging, Guangdong Provincial Second People’s Hospital, Guangzhou 510317, Guangdong Province, China
  • Received:2015-02-16 Online:2015-04-30 Published:2015-04-30
  • Contact: Xiao Cheng-jiang, Master, Chief physician, Interventional Department, Guangdong Provincial Second People’s Hospital, Guangzhou 510317, Guangdong Province, China
  • About author:Wei Wen-jiang, Master, Physician, Interventional Department, Guangdong Provincial Second People’s Hospital, Guangzhou 510317, Guangdong Province, China
  • Supported by:

    High Technology Fund of Guangdong Province, No. 2012B031800477

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摘要：

背景：为了避免机械取栓术中血栓脱落造成远端栓塞，作者以期运用微球囊临时隔截的方法来建立防止血栓脱落的保护装置。
目的：探讨采用微球囊临时阻断动脉血流并隔截栓塞段保护下行机械碎栓、吸栓联合溶栓治疗超急性脑梗死的安全性和可行性。
方法：Beagle犬10只在全身麻醉下经股动脉插管将微球囊导管送至优势侧椎动脉内并充盈球囊临时阻断血流，经微导管注入自体血栓建立椎动脉血栓栓塞模型，按治疗方法均分为2组，对照组采用单纯支架取栓，实验组采用微球囊导管临时阻断血流并隔截靶动脉后行机械碎栓吸栓联合药物溶栓。两组治疗后均行数字减影血管造影复查栓塞椎动脉再通状况；采用血栓性脑缺血血流分级进行血流动力学评估。造模前及取栓后12 h行磁共振弥散加权成像。建模后12 h行核磁共振成像检查后处死动物行病理检查，统计两组血管再通成功率及并发症。
结果与结论：10只beagle犬的优势侧椎动脉均成功出现血栓栓塞。对照组中2只犬椎动脉完全再通，3只犬椎动脉部分再通，其中1只犬椎-基底动脉与颅内动脉中可见多处小点状充盈缺损，颅内动脉显影差，对比剂返流，建模后12 h 磁共振弥散加权成像示左侧颞顶叶稍高信号影，病理检查示左侧大脑颞叶动脉腔内见血栓形成。实验组中5只犬椎动脉均完全再通，未见脑梗死。实验组血管再通率高于对照组(P < 0.05)。结果证实，在急性脑动脉栓塞血管再通中采用微球囊导管临时阻断血流并隔截靶动脉保护下机械碎栓、吸栓联合尿激酶溶栓，可有效防止小栓子脱落栓塞远端动脉，安全有效。



中国组织工程研究杂志出版内容重点：肾移植；肝移植；移植；心脏移植；组织移植；皮肤移植；皮瓣移植；血管移植；器官移植；组织工程


全文链接：

关键词: 实验动物, 脑及脊髓损伤模型, 球囊导管, 犬, 椎动脉, 模型, 磁共振, 数字减影血管造影, 血栓, 脑动脉栓塞, 机械碎栓, 支架取栓
   

Abstract:

BACKGROUND: In order to avoid distal arterial embolism following mechanical thrombectomy, micro-balloon catheter temporary isolation is applied to prevent thrombus shedding.
OBJECTIVE: To investigate the safety and feasibility of adopting the micro-balloon catheter technique in treatment of the hyperacute cerebral infarction. The micro-balloon catheter technique can temporarily block the artery blood flow and isolate the embolism location following mechanical thrombectomy and aspiration combined with thrombolysis.
METHODS: Ten beagle dogs were included in this study. Under general anesthesia, the micro-balloon catheter 
was delivered to the dominant vertebral artery through the femoral artery in all the dogs and it was filled and temporarily blocked the blood flow. Then the autologous thrombus was injected through the micro-catheter into proximal vertebral artery to make a thrombosis model. All the dogs were equally divided into two groups according to the embolectomy method: control group (receiving pure stent embolectomy, n=5) and experimental group (n=5). The experiment group was disrupted and aspirated thrombus combined with the drug thrombolysis after temporarily blocking out the blood flow and isolating the target artery by micro-balloon catheter technique. After treatment, two groups underwent digital subtraction angiography to review the vertebral artery recanalization after different embolectomy methods. The hemodynamic status was evaluated through the thrombolysis in cerebral ischemia grade. All the dogs were scanned with magnetic resonance diffusion weighted imaging before modeling and at 12 hours after the thrombectomy. The animals were killed to perform pathological examination after magnetic resonance diffusion weighted imaging (12 hours after the thrombectomy). The vessel recanalization rates and complications were calculated in the two groups.
RESULTS AND CONCLUSION: The thromboembolism model was successfully established in the dominant vertebral artery of all the 10 beagle dogs. In the control group, the vertebral arteries were completely successful recanalized in two dogs and were partly recanalized in three dogs, while the vertebral-basilar and intracranial arteries in one dog showed multiple small punctate filling defects with poor intracranial arterial development and contrast agent reflux. At 12 hours after embolectomy, the magnetic resonance diffusion weighted imaging showed slightly high signal intensity at the left temporoparietal lobe and the pathologic examination suggested thrombosis in the cerebral artery lumen of the left temporal lobe. In the experimental group, the vertebral arteries in five dogs were completely recanalized without infarction. The revascularization rate in the experimental group was significantly higher than that in the control group
(P < 0.05). Experimental findings indicate that, the application of disruption and aspiration thrombus combined with the drug thrombolysis after temporarily blocking the blood flow and isolating the target artery by micro-balloon catheter technique in treatment of hyperacute cerebral infarction, can effectively prevent the small embolus exfoliating, which can cause distal embolization. Thus, the micro-balloon catheter technique is a safe, effective and relatively inexpensive interventional embolectomy.



中国组织工程研究杂志出版内容重点：肾移植；肝移植；移植；心脏移植；组织移植；皮肤移植；皮瓣移植；血管移植；器官移植；组织工程


全文链接：

Key words: Tissue Engineering, Vertebral Artery, Magnetic Resonance Imaging, Thrombosis

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