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渐进性下腔静脉阻塞的 Ameroid 缩窄环模型:揭示肾门水平肿瘤血栓形成的血流动力学和代偿模式的犬模型。

Progressive Obstruction of Inferior Vena Cava by Ameroid Constrictor: The Canine Model of Revealing Hemodynamic and Compensatory Patterns of Tumor Thrombus Formation at the Renal Hilus Level.

机构信息

Department of Urology, the Third Medical Center, Chinese PLA General Hospital, Beijing, China.

Department of Radiology and the First Medical Center, Chinese PLA General Hospital, Beijing, China.

出版信息

J Endourol. 2022 Aug;36(8):1119-1125. doi: 10.1089/end.2021.0760. Epub 2022 Jul 11.

Abstract

To develop an efficient and stable canine model of inferior vena cava (IVC) progressive obstruction at the renal hilus level. The model was established in two beagles by encircling an ameroid constrictor (AC) on the IVC at the renal hilus level. Abdominal wall varicosity and animal weight variations were observed weekly after operation. Ultrasound examination was performed weekly after surgery to observe the AC position, the diameter, and the velocity in the IVC. Six weeks after surgery, IVC angiography and CT scan were performed to observe the collateral circulation establishment and internal organ variation. Blood samples were taken regularly to monitor for variation in critical biochemical parameters. Renal biopsy was performed at 0, 2, 4, and 6 weeks after surgery. Superficial varicose veins were observed on the abdominal wall at 2 weeks after surgery. Four weeks after operation, the IVC diameter increased by ∼30%, whereas the IVC velocity decreased by more than 50%. Collateral circulation was observed by IVC angiography at 6 weeks through multiple dilated veins along with neovascularization. CT scan showed congestive alteration in the kidney. The body weight, kidney, and liver function were not significantly affected. Chronic congestive renal injury was detected in the renal tubular epithelium by kidney biopsy after surgery. A canine model of IVC progressive obstruction at the renal hilus level was stably and safely established for the first time by using an AC, which may be helpful for preserving pivotal collateral circulation and nontumor-side kidney function in the IVC thrombus surgery.

摘要

建立一种在肾门水平稳定且高效的犬下腔静脉(IVC)渐进性阻塞模型。通过在肾门水平环绕 ameroid 缩窄器(AC),在两只比格犬中建立模型。术后每周观察腹壁静脉曲张和动物体重变化。术后每周进行超声检查,观察 AC 位置、IVC 直径和速度。术后 6 周进行 IVC 血管造影和 CT 扫描,观察侧支循环建立和内脏器官变化。定期采血监测关键生化参数的变化。术后 0、2、4 和 6 周进行肾脏活检。术后 2 周观察到腹壁浅表静脉曲张。术后 4 周,IVC 直径增加约 30%,而 IVC 速度降低超过 50%。6 周时通过多条扩张的静脉和新生血管进行 IVC 血管造影观察到侧支循环。CT 扫描显示肾脏充血改变。体重、肾脏和肝功能无明显影响。术后肾脏活检显示慢性充血性肾损伤,累及肾小管上皮。首次通过使用 AC 成功稳定地建立了犬肾门水平 IVC 渐进性阻塞模型,这可能有助于在 IVC 血栓形成手术中保护关键侧支循环和非肿瘤侧肾脏功能。

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