Department of Surgery, University of Nebraska Medical Center, Omaha, Nebraska; Department of Surgery and VA Research Service, Nebraska-Western Iowa Health Care System, Omaha, Nebraska.
Department of Surgery, University of Nebraska Medical Center, Omaha, Nebraska.
J Surg Res. 2020 May;249:168-179. doi: 10.1016/j.jss.2019.12.005. Epub 2020 Jan 24.
Development of collateral vasculature is key in compensating for arterial occlusions in patients with peripheral artery disease (PAD). We aimed to examine the development of collateral pathways after ligation of native vessels in a porcine model of PAD.
Right hindlimb ischemia was induced in domestic swine (n = 11) using two versions of arterial ligation. Version 1 (n = 6) consisted of ligation with division of the right external iliac, profunda femoral, and superficial femoral arteries. Version 2 (n = 5) consisted of the ligation of version 1 with additional ligation with division of the right internal iliac artery. Development of collateral pathways was evaluated with standard angiography before arterial ligation and at termination (30 days later). Relative luminal diameter of the arteries supplying the ischemic right hind limb were determined by two-dimensional angiography.
The dominant collateral pathway that developed after version 1 ligation connected the right internal iliac artery to the right profunda femoral and then to the right superficial femoral and popliteal artery. Mean luminal diameter of the right internal iliac artery at termination increased by 38% compared with baseline. Two codominant collateral pathways developed in version 2 ligation: (i) from the left profunda femoral artery to the reconstituted right profunda femoral artery and (ii) from the common internal iliac trunk and the left internal iliac artery to the reconstituted right internal iliac artery, which then supplied the right profunda femoral and then the right superficial femoral and popliteal artery. The mean diameter of the left profunda and the left internal iliac artery increased at termination by 26% and 21%, respectively (P < 0.05).
Two versions of hindlimb ischemia induction (right ilio-femoral artery ligation with and without right internal iliac artery ligation) in swine produced differing collateral pathways, along with changes to the diameter of the inflow vessels (i.e., arteriogenesis).
侧支血管的发展是外周动脉疾病（PAD）患者补偿动脉阻塞的关键。我们旨在检查在 PAD 猪模型中，在结扎天然血管后侧支途径的发展。
通过两种动脉结扎版本在国内猪中诱导右后肢缺血。版本 1（n=6）包括结扎右髂外动脉、股深动脉和股浅动脉并分离。版本 2（n=5）由结扎版本 1和结扎右髂内动脉并分离组成。在动脉结扎前和终末（30 天后）用标准血管造影术评估侧支途径的发展。通过二维血管造影术确定供应缺血右后肢的动脉的相对管腔直径。
在版本 1 结扎后形成的主要侧支途径将右髂内动脉连接到右股深动脉，然后连接到右股浅动脉和腘动脉。与基线相比，终末时右髂内动脉的平均管腔直径增加了 38%。在版本 2 结扎中形成了两条主要的侧支途径：（i）从左股深动脉到重建的右股深动脉，（ii）从共同的髂内干和左髂内动脉到重建的右髂内动脉，然后供应右股深动脉，然后供应右股浅动脉和腘动脉。终末时，左股深动脉和左髂内动脉的平均直径分别增加了 26%和 21%（P<0.05）。
在猪中，两种后肢缺血诱导版本（右髂股动脉结扎伴或不伴右髂内动脉结扎）产生了不同的侧支途径，以及流入血管（即动脉生成）的直径变化。
