Rothman A, Mann D M, House M T, Konopka R G, Chiles P G, Pedersen C A, Wolf P, Moser K M
Department of Pediatrics, University of California San Diego, USA.
J Am Coll Cardiol. 1996 Jan;27(1):218-24. doi: 10.1016/0735-1097(95)00422-X.
The aim of this study was to evaluate the performance of a new arterial biopsy catheter in obtaining pulmonary endovascular samples in a canine model.
Percutaneous endomyocardial biopsy is a widely used and valuable procedure in the management of posttransplant rejection and selected cardiomyopathies. A similar method of obtaining endoarterial biopsy samples would aid in the study, diagnosis and management of arterial diseases.
Catheterization was performed in 19 dogs, each weighing 20 to 30 kg, through an 8F sheath in the external jugular vein to obtain pulmonary endoarterial samples. The catheter consists of two sliding tubes: an inner one with a beveled opening that accommodates endoarterial tissue by means of a vacuum and an outer tube with a sharp distal edge that cuts the tissue when activated.
Overall, a total of 266 separate biopsy attempts were performed, and 161 tissue samples were obtained (success rate 61%). With modifications in technique in the last nine dogs, 54 (93%) of 58 attempts were successful. There were no deaths, extravasation of contrast material on angiography or thrombi. Of 20 vessels with prebiopsy and postbiopsy angiograms, 1 developed transient spasm (5%). On microscopic examination of cross sections of 50 separate pulmonary endoarterial biopsy samples, all had smooth muscle cells and 30 contained endothelial cells (60%). The arteries of origin showed small intimal and medial tears and mild perivascular hemorrhage. Angiographic and pathologic examination of previously biopsied arterial segments 2 weeks (two dogs) and 8 weeks (two dogs) after the procedure showed patent vessels and no thrombi. Histologically, the biopsy sites revealed mild neointimal and medial proliferation.
This new endoarterial biopsy catheter is safe and effective in obtaining pulmonary artery samples in normotensive dogs.
本研究旨在评估一种新型动脉活检导管在犬模型中获取肺血管内样本的性能。
经皮心内膜活检是移植后排斥反应和某些心肌病管理中广泛使用且有价值的操作。一种类似的获取动脉内活检样本的方法将有助于动脉疾病的研究、诊断和管理。
对19只体重20至30千克的犬，通过颈外静脉的8F鞘管进行插管，以获取肺动脉内样本。该导管由两个滑动管组成：一个内部带有斜面开口的管，通过真空容纳动脉内组织；另一个外部管带有尖锐的远端边缘，激活时可切割组织。
总体而言，共进行了266次单独的活检尝试，获取了161个组织样本（成功率61%）。在对最后9只犬的技术进行改进后，58次尝试中有54次（93%）成功。没有死亡、血管造影时造影剂外渗或血栓形成。在20条有活检前和活检后血管造影的血管中，1条出现短暂痉挛（5%）。在对50个单独的肺动脉内活检样本的横截面进行显微镜检查时，所有样本均有平滑肌细胞，30个样本含有内皮细胞（60%）。起源动脉显示有小的内膜和中膜撕裂以及轻度血管周围出血。在术后2周（2只犬）和8周（2只犬）对先前活检的动脉段进行血管造影和病理检查，显示血管通畅且无血栓形成。组织学上，活检部位显示有轻度内膜和中膜增生。
这种新型动脉内活检导管在获取正常血压犬的肺动脉样本方面安全有效。
