Condori Leandro Heber Ivan, Koshevaya Elena G, Mitrofanova Lubov B, Vakhrushev Aleksandr D, Goncharova Natalia S, Korobchenko Lev E, Andreeva Elizaveta M, Lebedev Dmitry S, Mikhaylov Evgeny N
Almazov National Medical Research Centre, 2 Akkuratova Str., 197341 Saint-Petersburg, Russia.
Int J Mol Sci. 2021 Aug 16;22(16):8788. doi: 10.3390/ijms22168788.
Pulmonary artery denervation (PADN) is an evolving interventional procedure capable to reduce pulmonary artery (PA) pressure. We aimed to compare PA nerve distribution in different specimens and assess the feasibility of an ovine model for a denervation procedure and evaluate the acute changes induced by laser energy.
The experiment was divided into two phases: (1) the analysis of PA nerve distribution in sheep, pigs, and humans using histological and immunochemical methods; (2) fiberoptic PADN in sheep and postmortem laser lesion characteristics.
PA nerve density and distribution in sheep differ from humans, although pigs and sheep share similar characteristics, nerve fibers are observed in the media layer, adventitia, and perivascular tissue in sheep. Necrosis of the intima and focal hemorrhages within the media, adventitia, and perivascular adipose tissue were evidenced post laser PADN. Among the identified lesions, 40% reached adventitia and could be classified as effective for PADN. The use of 20 W ablation energy was safer and 30 W-ablation led to collateral organ damage.
An ovine model is suitable for PADN procedures; however, nerve distribution in the PA bifurcation and main branches differ from human PA innervation. Laser ablation can be safely used for PADN procedures.
肺动脉去神经支配术（PADN）是一种不断发展的介入手术，能够降低肺动脉（PA）压力。我们旨在比较不同标本中的肺动脉神经分布，评估去神经支配手术绵羊模型的可行性，并评估激光能量引起的急性变化。
实验分为两个阶段：（1）使用组织学和免疫化学方法分析绵羊、猪和人类的肺动脉神经分布；（2）绵羊的纤维光学PADN及死后激光损伤特征。
绵羊的肺动脉神经密度和分布与人类不同，尽管猪和绵羊有相似特征，但在绵羊的中膜层、外膜和血管周围组织中观察到神经纤维。激光PADN术后可见内膜坏死以及中膜、外膜和血管周围脂肪组织内的局灶性出血。在已识别的病变中，40%延伸至外膜，可归类为对PADN有效。使用20W消融能量更安全，30W消融会导致附属器官损伤。
绵羊模型适用于PADN手术；然而，肺动脉分叉和主要分支中的神经分布与人类肺动脉神经支配不同。激光消融可安全用于PADN手术。
