McLeod Helen, Cox Ben F, Robertson James, Duncan Robyn, Matthew Shona, Bhat Raj, Barclay Avril, Anwar J, Wilkinson Tracey, Melzer Andreas, Houston J Graeme
Department of Metabolic and Clinical Medicine, Ninewells Hospital and Medical School, University of Dundee, Mailbox 1, Dundee, DD1 9SY, UK.
Institute for Medical Science and Technology, University of Dundee, Dundee, UK.
Cardiovasc Intervent Radiol. 2017 Sep;40(9):1454-1460. doi: 10.1007/s00270-017-1643-z. Epub 2017 Apr 27.
The purpose of this investigation was to evaluate human Thiel-embalmed cadavers with the addition of extracorporeal driven ante-grade pulsatile flow in the aorta as a model for simulation training in interventional techniques and endovascular device testing.
Three human cadavers embalmed according to the method of Thiel were selected. Extracorporeal pulsatile ante-grade flow of 2.5 L per min was delivered directly into the aorta of the cadavers via a surgically placed connection. During perfusion, aortic pressure and temperature were recorded and optimized for physiologically similar parameters. Pre- and post-procedure CT imaging was conducted to plan and follow up thoracic and abdominal endovascular aortic repair as it would be in a clinical scenario. Thoracic endovascular aortic repair (TEVAR) and endovascular abdominal repair (EVAR) procedures were conducted in simulation of a clinical case, under fluoroscopic guidance with a multidisciplinary team present.
The Thiel cadaveric aortic perfusion model provided pulsatile ante-grade flow, with pressure and temperature, sufficient to conduct a realistic simulation of TEVAR and EVAR procedures. Fluoroscopic imaging provided guidance during the intervention. Pre- and post-procedure CT imaging facilitated planning and follow-up evaluation of the procedure.
The human Thiel-embalmed cadavers with the addition of extracorporeal flow within the aorta offer an anatomically appropriate, physiologically similar robust model to simulate aortic endovascular procedures, with potential applications in interventional radiology training and medical device testing as a pre-clinical model.
本研究的目的是评估添加体外驱动的主动脉顺行搏动血流的人类蒂尔（Thiel）防腐尸体，作为介入技术模拟训练和血管内装置测试的模型。
选择3具按照蒂尔方法防腐处理的人类尸体。通过手术放置的连接装置，将每分钟2.5升的体外搏动性顺行血流直接输送到尸体的主动脉中。在灌注过程中，记录主动脉压力和温度，并针对生理相似参数进行优化。如同临床情况一样，进行术前和术后CT成像以规划和随访胸腹部血管内主动脉修复。在多学科团队在场且有荧光透视引导的情况下，模拟临床病例进行胸主动脉腔内修复术（TEVAR）和腹主动脉腔内修复术（EVAR）。
蒂尔尸体主动脉灌注模型提供了搏动性顺行血流以及压力和温度，足以对TEVAR和EVAR手术进行逼真的模拟。荧光透视成像在干预过程中提供了指导。术前和术后CT成像有助于手术的规划和随访评估。
添加主动脉内体外血流的人类蒂尔防腐尸体提供了一个解剖结构合适、生理状况相似的强大模型，可用于模拟主动脉血管内手术，在介入放射学培训和医疗器械测试中作为临床前模型具有潜在应用价值。
