Usón-Gargallo Jesús, Crisóstomo Verónica, Loscertales Beatriz, Sun Fei, Sánchez-Margallo Francisco M, Martín-Cancho Maria F, Maynar Manuel
Minimally Invasive Surgery Center, Cáceres, Spain.
J Invest Surg. 2006 Mar-Apr;19(2):97-104. doi: 10.1080/08941930600569415.
The purpose of this work was to develop an abdominal aortic aneurysm (AAA) model that resembles human aneurysms with potential for further growth, patent collateral vessels, and a predictable tendency to rupture, and that can be used in the development of new endoprostheses and implant training. An infrarenal AAA model was created in five domestic swine using an autologous gastric serosal patch. Pre- and postsurgical digital subtraction aortograms (DSA) were obtained to document the appearance and dimensions of the aneurysm. Animals were followed up with DSA and ultrasonography on days 7, 14, 30, 45, 60, and 90 after model creation. Aneurysmal diameters were measured with both techniques in all examinations. On day 90, animals were euthanized, target arteries were harvested, and pathological evaluation was performed. The nonparametric Wilcoxon test was used to assess any differences in measured diameters. All the animals survived the surgical procedure. The aneurysmal diameters increased from 8.14+/- 2.15 to 13.28+/- 1.18 mm immediately after surgery (p < .05), but no subsequent significant growth of the aneurysmal sac was seen during follow-up. In this experimental setting, measurements obtained with DSA were slightly larger than those obtained with ultrasound. Two animals died of AAA rupture on days 6 and 10 (40% rupture rate). Pathological examination showed lack of elastic laminae and increased collagen content in the aortic patch. Thus, model showed a tendency to rupture, but no significant potential for further aneurysmal growth. It might be useful for training in endovascular therapies, but its usefulness for preclinical endovascular device testing is limited by its lack of growth potential.
本研究的目的是建立一种腹主动脉瘤(AAA)模型,该模型类似于具有进一步生长潜力、侧支血管通畅且具有可预测破裂倾向的人类动脉瘤,可用于新型血管内假体的研发和植入训练。使用自体胃浆膜补片在5头家猪中创建了肾下腹主动脉瘤模型。术前和术后均进行数字减影主动脉造影(DSA)以记录动脉瘤的外观和尺寸。在模型创建后的第7、14、30、45、60和90天,对动物进行DSA和超声检查随访。在所有检查中均使用这两种技术测量动脉瘤直径。在第90天,对动物实施安乐死,采集目标动脉并进行病理评估。使用非参数Wilcoxon检验评估测量直径的任何差异。所有动物均在手术过程中存活。术后即刻动脉瘤直径从8.14±2.15 mm增加到13.28±1.18 mm(p <.05),但在随访期间未观察到动脉瘤囊的后续显著生长。在本实验环境中,DSA测量值略大于超声测量值。2只动物在第6天和第10天死于AAA破裂(破裂率40%)。病理检查显示主动脉补片中缺乏弹性层且胶原含量增加。因此,该模型显示出破裂倾向,但没有进一步动脉瘤生长的显著潜力。它可能对血管内治疗训练有用,但其在临床前血管内装置测试中的实用性因其缺乏生长潜力而受到限制。