Carrell T W, Smith A, Burnand K G
Academic Department of Surgery, St Thomas' Hospital, London, UK.
Br J Surg. 1999 Mar;86(3):305-12. doi: 10.1046/j.1365-2168.1999.01092.x.
It is still unclear what initiates aneurysmal dilatation and what determines whether or not an aneurysm will continue to expand and rupture. Early detection and operative repair of an abdominal aortic aneurysm (AAA) still remains the only effective means of reducing the high mortality rate associated with the condition. Endovascular techniques are being developed in an attempt to reduce the mortality rate associated with elective repair. A variety of animal models and experimental techniques have been described in the investigation of the pathophysiology of AAA and in the development of improved endovascular surgical and pharmacological therapies. This article discusses these models and techniques, their advantages and some of the problems encountered in extrapolating experimental findings to the human condition.
This review is based on a search of the Medline database from 1966 to March 1998 using recognized key words and text words. A further search was then conducted on references quoted within selected relevant publications.
Treatment of rodent aortas with intraluminal elastase or periaortic calcium chloride creates reproducible aneurysms that have certain similarities to the human pathology; such aneurysms have been favoured in the investigation of the pathophysiology of aneurysm expansion. However, these models lack several of the prominent features of the human lesion, such as atherosclerosis and intraluminal thrombosis. The development of gene knockout mice may lead to a more analogous aneurysm formation, with associated atherosclerosis. Many large animal models have been used in the development of endovascular techniques but, in general, these do not mimic the human pathophysiology and fail to predict medium- and long-term complications.
目前仍不清楚是什么引发了动脉瘤扩张，以及是什么决定了动脉瘤是否会继续扩大并破裂。腹主动脉瘤（AAA）的早期检测和手术修复仍然是降低与该疾病相关的高死亡率的唯一有效手段。血管内技术正在不断发展，以试图降低与择期修复相关的死亡率。在AAA病理生理学研究以及改进血管内手术和药物治疗的开发过程中，已经描述了多种动物模型和实验技术。本文讨论了这些模型和技术、它们的优点以及将实验结果外推至人类情况时遇到的一些问题。
本综述基于使用公认的关键词和文本词对1966年至1998年3月期间的Medline数据库进行的检索。然后对选定相关出版物中引用的参考文献进行了进一步检索。
用腔内弹性蛋白酶或主动脉周围氯化钙处理啮齿动物主动脉可产生可重复的动脉瘤，这些动脉瘤与人的病理学有一定相似之处；此类动脉瘤在动脉瘤扩张病理生理学研究中受到青睐。然而，这些模型缺乏人类病变的几个突出特征，如动脉粥样硬化和腔内血栓形成。基因敲除小鼠的发展可能会导致形成更类似的动脉瘤，并伴有动脉粥样硬化。许多大型动物模型已用于血管内技术的开发，但总体而言，这些模型无法模拟人类病理生理学，也无法预测中长期并发症。
