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在大型猪动物模型中诱导持续性扩张的肾下腹主动脉瘤。

Induction of continuous expanding infrarenal aortic aneurysms in a large porcine animal model.

作者信息

Kloster Brian O, Lund Lars, Lindholt Jes S

机构信息

Vascular Research Unit, Department of Vascular Surgery, Viborg Regional Hospital, Heibergs Alle 4, 8800 Viborg, Denmark.

Department of Urology, OUH Odense University Hospital, Sdr. Boulevard 29, 5000 Odense C, Denmark.

出版信息

Ann Med Surg (Lond). 2015 Jan 14;4(1):30-5. doi: 10.1016/j.amsu.2014.10.001. eCollection 2015 Mar.

Abstract

BACKGROUND

A large animal model with a continuous expanding infrarenal aortic aneurysm gives access to a more realistic AAA model with anatomy and physiology similar to humans, and thus allows for new experimental research in the natural history and treatment options of the disease.

METHODS

10 pigs (group A) underwent infrarenal aortic dissection, balloon dilatation, infusion of elastase into the lumen and placement of a stenosing cuff around the aorta. 10 control pigs (group B) underwent a sham procedure. The subsequent 28 days the AP-diameters of the aneurysms were measured using ultrasound, hereafter the pigs were euthanized for inspection and AAA wall sampling for histological analysis.

RESULTS

In group A, all pigs developed continuous expanding AAA's with a mean increase in AP-diameter to 16.26 ± 0.93 mm equivalent to a 57% increase. In group B the AP-diameters increased to 11.33 ± 0.13 mm equivalent to 9.3% which was significantly less than in group A (p < 0.001). In group A, a significant negative association between the preoperative weight and the resulting AP-diameters was found. Histology shoved more or less complete resolution of the elastic tissue in the tunica media in group A. The most frequent complication was a neurological deficit in the lower limbs.

CONCLUSION

In pigs it's possible to induce continuous expanding AAA's based upon proteolytic degradation and pathological flow, resembling the real life dynamics of human aneurysms. Because the lumbars are preserved, it's also a potential model for further studies of novel endovascular devices and their complications.

摘要

背景

一种具有持续扩张性肾下腹主动脉瘤的大型动物模型,可提供一个解剖结构和生理机能与人类相似的更逼真的腹主动脉瘤模型,从而有助于开展关于该疾病自然史和治疗方案的新实验研究。

方法

10头猪(A组)接受肾下腹主动脉夹层分离、球囊扩张、向管腔内注入弹性蛋白酶以及在主动脉周围放置狭窄套囊。10头对照猪(B组)接受假手术。在随后的28天内,使用超声测量动脉瘤的前后径,之后对猪实施安乐死以进行检查并采集腹主动脉瘤壁样本进行组织学分析。

结果

在A组中,所有猪均形成了持续扩张的腹主动脉瘤,前后径平均增加至16.26±0.93毫米,相当于增加了57%。在B组中,前后径增加至11.33±0.13毫米,相当于增加了9.3%,显著低于A组(p<0.001)。在A组中,发现术前体重与最终的前后径之间存在显著的负相关。组织学检查显示A组中膜的弹性组织或多或少完全溶解。最常见的并发症是下肢神经功能缺损。

结论

在猪身上,基于蛋白水解降解和病理性血流,有可能诱导出持续扩张的腹主动脉瘤,类似于人类动脉瘤的实际动态变化。由于保留了腰段血管,它也是进一步研究新型血管内装置及其并发症的潜在模型。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/739f/4323759/b5226b9d6a51/gr1.jpg

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