Macierewicz J A, Albertini J-N, Hinchliffe R J
Department of Vascular Surgery, Doncaster Royal Infirmary, Doncaster, UK.
Vascular. 2011 Apr;19(2):82-8. doi: 10.1258/vasc.2010.oa0262.
Reliable models of aortic aneurysms are required to test endovascular stent-graft technology prior to human use. We describe the creation of a standardized prosthetic aneurysm in an ovine model to assess endovascular technology. In an adult ovine model under general anesthesia, a polyester sphere measuring 6 cm across was sutured onto the infrarenal aorta following aortotomy. Two weeks later an endovascular stent-graft was deployed in the aorta. Exclusion was confirmed on monthly ultrasound duplex and during angiography at three months and under terminal anesthesia at six months. Autopsy along with histology of the specimen were then performed. A total of 10 sheep underwent aneurysm implantation. Nine received a straight tube endovascular stent-graft (Lombard Medical, Abingdon, Oxon, UK) and seven completed the study. Five prosthetic aneurysms shrank during serial imaging with duplex ultrasound and angiography. However, two remained the same size. One of these had a type I endoleak whereas the other had endotension (type I endoleak confirmed at autopsy). This animal model provides a reliable and reproducible method of creating prosthetic aneurysms for assessing endovascular stent-grafts. It was possible to assess aneurysm exclusion non-invasively using duplex ultrasound. Aneurysms effectively excluded from the circulation shrank whereas those with an endoleak did not.
在人体使用之前，需要可靠的主动脉瘤模型来测试血管内支架移植物技术。我们描述了在绵羊模型中创建标准化人工动脉瘤以评估血管内技术的过程。在全身麻醉下的成年绵羊模型中，在主动脉切开术后将一个直径6厘米的聚酯球缝合到肾下腹主动脉上。两周后，在主动脉中部署血管内支架移植物。每月通过超声双功检查确认隔绝情况，并在三个月时进行血管造影，六个月时在终末麻醉下进行血管造影。然后进行尸体解剖并对标本进行组织学检查。共有10只绵羊接受了动脉瘤植入。9只接受了直管型血管内支架移植物（Lombard Medical，英国阿宾登，牛津郡），7只完成了研究。在超声双功和血管造影的系列成像过程中，5个人工动脉瘤缩小。然而，2个大小保持不变。其中一个有I型内漏，另一个有内张力（尸检时确认有I型内漏）。这种动物模型为创建用于评估血管内支架移植物的人工动脉瘤提供了一种可靠且可重复的方法。使用超声双功可以无创地评估动脉瘤隔绝情况。有效隔绝于循环系统的动脉瘤缩小，而有内漏的动脉瘤则不会缩小。
