Etienne Harry, Journé Clément, Rouchaud Aymeric, Senemaud Jean, Louedec Liliane, Pellenc Quentin, Coscas Raphaël, Gouya Laurent, Dupont Sébastien, Michel Jean-Baptiste
UMR 1148, Inserm-Denis Diderot University, Hôpital Xavier Bichat, Paris, France,
UMR 1148, Inserm-Denis Diderot University, Hôpital Xavier Bichat, Paris, France.
J Vasc Res. 2020;57(3):164-176. doi: 10.1159/000506159. Epub 2020 Mar 27.
Saccular aneurysms are thought to have a worse prognosis than fusiform aneurysms in humans, due to hemodynamic reasons. However, data comparing hemodynamic and biology in saccular and fusiform aneurysms are lacking. The main objective was to evaluate the impact of aneurysm morphology on intra-luminal thrombus (ILT) formation and activity.
Forty Lewis rats were ran-domly divided into 2 groups of 20: "saccular" (Group A) and "fusiform" (Group B) aneurysms. Decellularized thoracic aortas from guinea pigs were xenografted to create saccular or fusiform aneurysms. Final imaging evaluation of the aneurysms was carried out during the third week, by quantitative Doppler ultrasound and magnetic resonance imaging. Assays of myeloperoxidase (MPO), platelet factor 4 (PF4), advanced oxidation protein products (AOPPs) iron and matrix metallopeptidase-9 (MMP-9) were performed as biological criteria.
Quantitatively, saccular aneurysms are characterized by a more thicker ILT, lower inflow velocities and more important relative backflow velocities as compared to fusiform aneurysms. Compared to fusiform, saccular aneurysms released significantly more MPO (p = 0.004), PF4 (p = 0.02), AOPPs (p < 0.002), iron (p < 0.0001) and MMP-9 (p < 0.04).
Experimental saccular and fusiform aneurysms show differential specific hemodynamics, which seem to impact the histology and the biology of the ILT in each type of aneurysm.
由于血流动力学原因，人们认为在人类中，囊状动脉瘤的预后比梭形动脉瘤更差。然而，缺乏比较囊状和梭形动脉瘤血流动力学及生物学特征的数据。主要目的是评估动脉瘤形态对腔内血栓（ILT）形成及活性的影响。
40只Lewis大鼠被随机分为两组，每组20只：“囊状”（A组）和“梭形”（B组）动脉瘤。将豚鼠脱细胞胸主动脉进行异种移植以形成囊状或梭形动脉瘤。在第三周通过定量多普勒超声和磁共振成像对动脉瘤进行最终影像学评估。进行髓过氧化物酶（MPO）、血小板因子4（PF4）、晚期氧化蛋白产物（AOPPs）、铁和基质金属蛋白酶-9（MMP-9）的检测作为生物学指标。
定量分析显示，与梭形动脉瘤相比，囊状动脉瘤具有更厚的ILT、更低的流入速度和更显著的相对回流速度。与梭形动脉瘤相比，囊状动脉瘤释放的MPO（p = 0.004）、PF4（p = 0.02）、AOPPs（p < 0.002）、铁（p < 0.0001）和MMP-9（p < 0.04）明显更多。
实验性囊状和梭形动脉瘤表现出不同的特定血流动力学特征，这似乎会影响每种类型动脉瘤中ILT的组织学和生物学特性。
