Kezurer Noa, Heldenberg Eitan, Farah Nairouz, Ivzan Nadav, Mandel Yossi
IEEE Trans Biomed Eng. 2018 Nov 23. doi: 10.1109/TBME.2018.2883212.
In this study we present a novel approach for inducing vasoconstriction by pulsed electrical treatment delivered via endovascular electrodes, which can be used in cases where external access to the vessel is limited.
Using computer simulations, we optimized various geometries of endovascular electrodes to maximize the induced electric field on the arterial wall. Using the optimal configuration parameters, we investigated endovascular induced vasoconstriction in both the carotid and femoral sheep arteries.
Endovascular electrodes induced robust vasoconstriction in the carotid artery of sheep, showing gradual recovery following treatment. Moreover, the obtained vasoconstriction was accompanied by a sevenfold decrease in blood loss for 100% constriction, compared with no treatment (6ml vs 42ml, p<0.001). The femoral artery was less amenable to the electrical treatment, which we hypothesize results from the reduced density of the sympathetic system's innervation of the adventitia of the sheep femoral artery, as was validated by immunohistochemical analysis. Finally, treatment safety was validated through arterial histological studies, in which no adverse effect was observed, and through computer modeling, which depicted a negligible temperature increase.
These results are an important step toward developing a novel approach for inducing reversible and controlled vasoconstriction in arteries that are remote from access.
在本研究中，我们提出了一种通过血管内电极进行脉冲电治疗来诱导血管收缩的新方法，该方法可用于血管外部通路受限的情况。
我们使用计算机模拟，优化了血管内电极的各种几何形状，以最大化动脉壁上感应的电场。利用最佳配置参数，我们研究了绵羊颈动脉和股动脉内血管诱导的血管收缩情况。
血管内电极在绵羊颈动脉中诱导了强烈的血管收缩，治疗后显示出逐渐恢复。此外，与未治疗相比，在100%收缩时获得的血管收缩伴随着失血量减少了七倍（6毫升对42毫升，p<0.001）。股动脉对电治疗的反应较差，我们推测这是由于绵羊股动脉外膜交感神经系统神经支配密度降低所致，免疫组织化学分析证实了这一点。最后，通过动脉组织学研究验证了治疗安全性，其中未观察到不良反应，并且通过计算机建模显示温度升高可忽略不计。
这些结果是朝着开发一种在难以触及的动脉中诱导可逆和可控血管收缩的新方法迈出的重要一步。
