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评价一种新的兔后肢缺血模型。

Evaluation of a new model of hind limb ischemia in rabbits.

机构信息

Vascular and Oncological Interventional Radiology, Université Paris Descartes, Hôpital Européen George Pompidou, Paris, France; Institut National de la Santé et de la Recherche Médicale (INSERM), UMRS-970, Centre de Recherche Cardiovasculaire, Université Paris Descartes, Sorbonne Paris Cité, Paris, France.

Institut National de la Santé et de la Recherche Médicale (INSERM), UMRS-970, Centre de Recherche Cardiovasculaire, Université Paris Descartes, Sorbonne Paris Cité, Paris, France.

出版信息

J Vasc Surg. 2018 Sep;68(3):849-857. doi: 10.1016/j.jvs.2017.07.140. Epub 2017 Oct 23.

Abstract

OBJECTIVE

Various animal models of critical limb ischemia have been developed in the past. However, there is no animal model that can undergo endovascular treatment, while providing reproducible true critical limb ischemia with arterial ulcers and rest pain. We evaluated the efficacy of a new model of rabbit hindlimb ischemia created through a percutaneous approach using embolization with calibrated particles.

METHODS

Through a percutaneous transauricular artery approach and selective catheterization of the superficial femoral artery, embolization of distal limb vessels was performed using a mixture of 300- to 500-μm calibrated microparticles (Embosphere, Merit Medical, Salt Lake City, Utah), saline solution, and iodine contrast. Clinical and ultrasound imaging-based blood flow evaluation was performed before embolization and during follow-up. Histologic evaluation was performed at humane killing 14 days after the procedure.

RESULTS

The model was successfully created in 10 rabbits (10 limbs). One rabbit died of sudden death at 8 days after the procedure. The nine surviving rabbits developed hind ulcers. All rabbits had a higher pain score in the follow-up compared to baseline value (P < .0001). Blood flow in the saphenous artery decreased significantly after the procedure and later at 14 days follow-up (baseline value 63.4 ± 31.3 μL per cardiac cycle vs 32.0 ± 28.4 μL per cardiac cycle postprocedure [P = .0013] and 32.0 ± 28.4 μL per cardiac cycle at 14 days [P = .0015]). Pathology showed signs of severe limb ischemia in all rabbits with subacute and chronic injury patterns.

CONCLUSIONS

A rabbit hind limb ischemia model created by percutaneous transauricular distal femoral artery embolization with calibrated particles may overcome some of the limitations of existing animal models. As such, this model could prove useful for assessing therapies designed to improve arterial perfusion and collateral growth.

摘要

目的

过去已经开发出各种用于治疗严重肢体缺血的动物模型。然而,目前还没有一种动物模型可以进行血管内治疗,同时提供具有动脉溃疡和静息痛的可重现的真正严重肢体缺血。我们评估了通过经皮途径使用校准颗粒栓塞创建的新兔后肢缺血模型的疗效。

方法

通过经皮经耳动脉途径和选择性股浅动脉插管,使用 300-500μm 校准微球(Embosphere,犹他州盐湖城 Merit Medical 公司)、生理盐水和碘对比剂的混合物对肢体远端血管进行栓塞。栓塞前和随访期间进行临床和超声成像血流评估。术后 14 天进行组织学评估。

结果

该模型在 10 只兔子(10 条肢体)中成功创建。一只兔子在术后 8 天突然死亡。9 只存活的兔子出现后肢溃疡。与基线值相比,所有兔子在随访期间的疼痛评分均升高(P<0.0001)。手术后,隐静脉血流量明显下降,随后在 14 天随访时也下降(基线值为每心脏周期 63.4±31.3μL 比术后每心脏周期 32.0±28.4μL[P=0.0013],术后 14 天每心脏周期 32.0±28.4μL[P=0.0015])。所有兔子的病理检查均显示出严重肢体缺血的迹象,伴有亚急性和慢性损伤模式。

结论

通过经皮经耳后股浅动脉栓塞使用校准颗粒创建的兔后肢缺血模型可能克服了现有动物模型的一些局限性。因此,这种模型可能对评估旨在改善动脉灌注和侧支生长的治疗方法很有用。

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