Marty-Ané C, Serres-Cousiné O, Laborde J C, Costes V, Alauzen M, Mary H
Service de Chirurgie Thoracique et Vasculaire, Hôpital Arnaud de Villeneuve, Montpellier, France.
Ann Vasc Surg. 1994 Sep;8(5):434-42. doi: 10.1007/BF02133063.
This study was designed to evaluate the potential obliteration of an experimental aortic dissection using an intravascular stent introduced via the femoral artery. Twenty-two adult dogs were divided into four groups: in group A (n = 6) a thoracoabdominal aortic dissection was surgically created to observe the natural course of this lesion; in group B (n = 6) a nitinol coil graft was introduced into the aorta via the femoral artery; in group C (n = 3) a nitinol coil graft was introduced via the femoral artery into a dissected aorta in an attempt to obliterate the dissection; and in group D (n = 7) an expandable intraluminal vascular graft (Palmaz stent) was introduced via the femoral artery into a dissected aorta in an attempt to obliterate the dissection. Arteriographic evaluation was performed postoperatively and again 6 weeks later before the aortas were explanted. Gross and light microscopic examinations were performed on all explanted aortas. In group A dissection was achieved and a postoperative aortogram demonstrated evidence of aortic dissection in all animals. Autopsy revealed persistence of dissection with a reentry tear near the celiac axis in five animals. In group B there was incomplete expansion of the nitinol coil graft in five dogs, resulting in aortic thrombosis in one. In group C the nitinol coil graft failed to obliterate the aortic dissection in all animals and resulted in aortic thrombosis in two. In group D placement of a balloon-expandable intraluminal stent solely at entry and reentry sites resulted in only partial obliteration of the dissection (n = 3), but when the entire length of the dissected aorta was treated, the dissection was completely obliterated (n = 3).
本研究旨在评估经股动脉置入血管内支架对实验性主动脉夹层的潜在闭塞效果。22只成年犬被分为四组：A组（n = 6）通过手术制造胸腹主动脉夹层以观察该病变的自然病程；B组（n = 6）经股动脉将镍钛合金线圈移植物置入主动脉；C组（n = 3）经股动脉将镍钛合金线圈移植物置入已切开的主动脉，试图闭塞夹层；D组（n = 7）经股动脉将可扩张腔内血管移植物（帕尔马兹支架）置入已切开的主动脉，试图闭塞夹层。术后及6周后在取出主动脉前再次进行血管造影评估。对所有取出的主动脉进行大体和光学显微镜检查。A组成功制造出夹层，术后主动脉造影显示所有动物均有主动脉夹层迹象。尸检发现5只动物夹层持续存在，在腹腔动脉轴附近有再入口撕裂。B组5只犬的镍钛合金线圈移植物扩张不完全，导致1只犬发生主动脉血栓形成。C组镍钛合金线圈移植物未能在所有动物中闭塞主动脉夹层，导致2只犬发生主动脉血栓形成。D组仅在入口和再入口部位放置球囊可扩张腔内支架仅导致夹层部分闭塞（n = 3），但当治疗已切开主动脉的全长时，夹层完全闭塞（n = 3）。
