Department of Pathology, Medical Faculty of Ataturk University, Erzurum, Turkey.
Department of Anesthesiology, Medical Faculty of Ataturk University, Erzurum, Turkey.
Neuropathology. 2020 Oct;40(5):467-473. doi: 10.1111/neup.12655. Epub 2020 Jul 16.
Fatal pulmonary edema and hemorrhage are significant complications of endovascular treatment in steno-occlusive carotid artery disease; a rational mechanism has not been adequately examined in the literature so far. We investigated if cervical sympathetic ganglia ischemia prevents pulmonary vasospasm on the prognosis of bilateral common carotid artery ligation (BCCAL). Twenty-three adult New Zealand rabbits (4.2 ± 0.3 kg) were randomly divided into three groups: the control group (G1, n = 5), the sham group (G2, n = 6), and the BCCAL group (G3, n = 12). Common carotid arteries were dissected bilaterally in G2/G3, and permanent BCCAL was applied to only in G3. All animals were followed for 3 weeks and decapitated under general anesthesia. Histopathological changes in stellate ganglia and severity of pulmonary vasospasm-related lung edema and hemorrhage were investigated. Results were analyzed by the Kruskal-Wallis test. Two animals of G3 dead within three weeks and the remainder were sacrificed three weeks later. Subpleural petechial foci and an endotracheal bloody fluid collection were grossly observed in the lungs. Histopathologically, pulmonary artery vasospasm, perivascular and subintimal edema, interalveolar hemorrhage, and alveolar wall destructions were observed with less ischemic-degenerated neuron density-determined stellate ganglia animals. Neurodegeneration of stellate ganglia may have a beneficial effect on the prevention of lung injury during steno-occlusive carotid artery disease.
致命性肺出血和肺水肿是血管内治疗狭窄性颈动脉疾病的严重并发症；目前文献中尚未充分检查其合理的发病机制。我们研究了颈交感神经节缺血是否能预防双侧颈总动脉结扎（BCCAL）后的肺血管痉挛。23 只成年新西兰兔（4.2±0.3kg）随机分为三组：对照组（G1，n=5）、假手术组（G2，n=6）和 BCCAL 组（G3，n=12）。G2/G3 双侧颈总动脉解剖，仅在 G3 应用永久性 BCCAL。所有动物均随访 3 周，全身麻醉下断头。研究星状神经节的组织病理学变化以及与肺血管痉挛相关的肺水肿和肺出血的严重程度。采用 Kruskal-Wallis 检验分析结果。G3 中有 2 只动物在 3 周内死亡，其余动物在 3 周后处死。肺肉眼可见肋胸膜下瘀点和气管内血性液体积聚。组织病理学上，观察到肺动脉血管痉挛、血管周围和内膜下水肿、肺泡内出血和肺泡壁破坏，伴有星状神经节缺血性退变神经元密度降低的动物。星状神经节的神经退行性变可能对预防狭窄性颈动脉疾病中的肺损伤有有益作用。
