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通过微导管向犬的小脑延髓池单次注射血液以诱发迟发性脑血管痉挛:实验研究

Single blood injection into the ventral cisterna magna through a microcatheter for the production of delayed cerebral vasospasm: experimental study in dogs.

作者信息

Mizuno Takamasa, Hamada Jun-Ichiro, Kai Yutaka, Todaka Tatemi, Morioka Motohiro, Ushio Yukitaka

机构信息

Department of Neurosurgery, Kumamoto University School of Medicine, Japan.

出版信息

AJNR Am J Neuroradiol. 2003 Apr;24(4):608-12.

Abstract

BACKGROUND AND PURPOSE

We developed an experimental canine subarachnoid hemorrhage (SAH) model in which one-time blood injection by means of a microcatheter into the ventral cisterna magna (CM) is performed without direct CM puncture. We assessed the severity and duration of the vasospasm produced in this model.

METHODS

Fresh autologous blood (0.25 or 0.5 ml/kg) or saline (0.5 ml/kg) was injected into the ventral CM of dogs through a microcatheter inserted at the lumbar region. Serial angiograms were obtained on days 3, 7, 10, and 14, and chronologic changes in the mean diameter of the basilar artery (BA) were recorded. The BA was examined histologically on day 7 after injection.

RESULTS

A remarkable amount of clot was present in front of the brain stem at 24 hours after SAH induction. The clot was smaller in the 0.25 ml/kg SAH than in the 0.5 ml/kg SAH group. On day 3, narrowing of the BA was apparent in both SAH groups compared with the control (P <.05). The BA gradually returned to nearly normal on day 14 in the 0.25 ml/kg SAH group. Arterial narrowing was more severe and persistent in the 0.5 ml/kg SAH than in the 0.25 ml/kg SAH group (P <.05). Histologic examination of the BA on the 7th postinjection day confirmed narrowing of the lumen, indicative of arterial spasm, in both SAH groups.

CONCLUSION

Our method of SAH induction by means of a single injection of blood directly into the ventral CM through a microcatheter induced severe, prolonged spasms in the canine BA. Because our model facilitates the induction of different-sized clots, we could control of the severity and duration of the induced vasospasms.

摘要

背景与目的

我们建立了一种实验性犬蛛网膜下腔出血(SAH)模型,该模型通过微导管一次性将血液注入腹侧大池(CM),而无需直接穿刺CM。我们评估了该模型中产生的血管痉挛的严重程度和持续时间。

方法

通过插入腰椎区域的微导管,将新鲜自体血(0.25或0.5 ml/kg)或生理盐水(0.5 ml/kg)注入犬的腹侧CM。在第3、7、10和14天获得系列血管造影,并记录基底动脉(BA)平均直径的时间变化。在注射后第7天对BA进行组织学检查。

结果

SAH诱导后24小时,脑干前方出现大量血凝块。0.25 ml/kg SAH组的血凝块比0.5 ml/kg SAH组小。与对照组相比,在第3天,两个SAH组的BA均明显变窄(P <.05)。在0.25 ml/kg SAH组中,BA在第14天逐渐恢复至接近正常。0.5 ml/kg SAH组的动脉狭窄比0.25 ml/kg SAH组更严重且持续时间更长(P <.05)。注射后第7天对BA的组织学检查证实,两个SAH组的管腔均变窄,提示动脉痉挛。

结论

我们通过微导管将血液直接单次注入腹侧CM诱导SAH的方法,在犬BA中诱导了严重、持久的痉挛。由于我们的模型便于诱导不同大小的血凝块,因此我们能够控制诱导的血管痉挛的严重程度和持续时间。

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