Reffelmann Thorsten, Sensebat Oezgun, Birnbaum Yochai, Stroemer Ewa, Hanrath Peter, Uretsky Barry F, Schwarz Ernst R
Medizinische Klinik I, University Hospital, Rheinisch-Westfälische Technische Hochschule (RWTH) Aachen, Germany.
Coron Artery Dis. 2004 Feb;15(1):7-12. doi: 10.1097/00019501-200402000-00002.
Most animal studies on myocardial infarction (MI) have used open-chest models with direct surgical coronary artery ligation, which imply local as well as generalized side effects of major surgery. Some closed-chest models of MI have been established, mainly using catheterization techniques with coronary artery embolization, balloon occlusion, and intracoronary injection of thrombogenic agents. The aim of this study was to develop a closed-chest technique of chronic coronary artery occlusion at a selected location with subsequent thrombus formation without use of balloon inflation or thrombotic chemical agents.
A coronary angiography via the carotid artery was performed using a 7 F guiding catheter in 21 pigs. After insertion of a percutaneous transluminal coronary angioplasty (PTCA) guide wire into the distal coronary artery, a vessel-size adapted flexible foreign body comprising an open-cell sponge was advanced into the coronary artery via the guide wire by a non-inflated PTCA balloon. Five min after removal of the guide wire and the balloon catheter, total coronary artery occlusion was documented by angiography. Retrograde thrombosis of the coronary artery occurred in three animals. After one week, total vessel occlusion at the previously selected location was visualized by coronary angiography in animals that had survived. Macroscopic analysis demonstrated the foreign body with subsequent thrombus formation in the coronary artery and distal MI. Post-mortem histological analysis revealed myocardial necrosis and granulocyte infiltration at the margin of the infarction, without damage to remote myocardium.
This new easy-to-perform closed-chest technique provides reproducible chronic coronary artery occlusion at a selected location with subsequent MI. It avoids major surgery and thoracotomy and does not require balloon inflation or intracoronary injection of thrombotic or chemical agents.
大多数关于心肌梗死（MI）的动物研究使用的是开胸模型，通过直接手术结扎冠状动脉，这意味着大手术存在局部以及全身性副作用。已经建立了一些心肌梗死的闭胸模型，主要采用冠状动脉栓塞、球囊闭塞和冠状动脉内注射血栓形成剂等导管技术。本研究的目的是开发一种闭胸技术，在选定位置实现慢性冠状动脉闭塞并随后形成血栓，而无需使用球囊扩张或血栓形成化学剂。
使用7F引导导管对21头猪进行经颈动脉冠状动脉造影。在将经皮冠状动脉腔内血管成形术（PTCA）导丝插入冠状动脉远端后，通过未充气的PTCA球囊将一个由开孔海绵制成的与血管大小适配的柔性异物经导丝推进冠状动脉。移除导丝和球囊导管5分钟后，血管造影显示冠状动脉完全闭塞。3只动物发生冠状动脉逆行血栓形成。一周后，存活动物经冠状动脉造影显示先前选定位置的血管完全闭塞。宏观分析显示冠状动脉内有异物并随后形成血栓以及远端心肌梗死。尸检组织学分析显示梗死边缘有心肌坏死和粒细胞浸润，而远端心肌未受损。
这种新的易于实施的闭胸技术可在选定位置实现可重复的慢性冠状动脉闭塞并随后发生心肌梗死。它避免了大手术和开胸，并且不需要球囊扩张或冠状动脉内注射血栓形成剂或化学剂。
