福格蒂球囊导管和经皮腔内冠状动脉成形术球囊损伤对动脉壁造成的损害相当，但会导致不同的愈合反应。

Fogarty and percutaneous transluminal coronary angioplasty balloon injury induce comparable damage to the arterial wall but lead to different healing responses.

作者信息

Doornekamp F N, Borst C, Haudenschild C C, Post M J

机构信息

Heart Lung Institute, Utrecht University Hospital, The Netherlands.

出版信息

J Vasc Surg. 1996 Nov;24(5):843-50. doi: 10.1016/s0741-5214(96)70021-6.

DOI:10.1016/s0741-5214(96)70021-6

PMID:8918332

Abstract

PURPOSE

Fogarty balloon denudation in experimental animals often serves as a model for percutaneous transluminal coronary angioplasty (PTCA). We compared the healing response of the arterial wall with the use of Fogarty and PTCA balloon dilation.

METHODS

Carotid arteries of rabbits were injured with a 2F Fogarty (n = 9) or a 3 mm PTCA balloon (n = 6). At 1 day endothelial cell removal was qualitatively evaluated in Fogarty balloon lesions and in PTCA balloon lesions with a modified "en face" silver nitrate staining. Medial necrosis was morphometrically determined as percentage medial area. After 21 days endothelial cell coverage was assessed in the center of the lesion with an antibody to CD31 and intimal proliferation with an antibody to the nuclear antigen Ki-67. Intimal hyperplasia area was measured with morphometry. Acute lumen gain directly after Fogarty balloon dilation and PTCA balloon dilation was determined by serial angiography. All data are means +/- SEM.

RESULTS

At 21 days intimal hyperplasia area was higher in the Fogarty balloon lesions than in the PTCA balloon lesions. Intimal hyperplasia area was 0.19 +/- 0.02 mm2 and 0.03 +/- 0.01 mm2, respectively. Immediately after injury the acute gain in luminal diameter did not differ between Fogarty and PTCA balloon dilation (0.37 +/- 0.03 mm and 0.38 +/- 0.05 mm, respectively). At 1 day after injury endothelial cell removal was complete in all segments. Medial necrosis caused by Fogarty (67% +/- 7%) and PTCA balloon dilation (74% +/- 9%) did not differ. At 21 days endothelial cell coverage was almost complete both in the Fogarty balloon lesions and in the PTCA balloon lesions. Intimal proliferation was also higher in the Fogarty balloon lesions than in the PTCA balloon lesions.

CONCLUSION

Despite comparable endothelial cell abrasion and medial necrosis, Fogarty balloon injury elicited significantly augmented intimal hyperplasia compared with PTCA balloon dilation.

摘要

目的

在实验动物中，Fogarty球囊剥脱术常作为经皮腔内冠状动脉成形术（PTCA）的模型。我们比较了使用Fogarty球囊和PTCA球囊扩张时动脉壁的愈合反应。

方法

用2F Fogarty球囊（n = 9）或3 mm PTCA球囊（n = 6）损伤兔的颈动脉。在第1天，采用改良的“正面”硝酸银染色对Fogarty球囊损伤和PTCA球囊损伤处的内皮细胞剥脱情况进行定性评估。通过形态计量学测定中膜坏死面积占中膜面积的百分比。21天后，用抗CD31抗体评估损伤中心的内皮细胞覆盖情况，用抗核抗原Ki-67抗体评估内膜增殖情况。用形态计量学测量内膜增生面积。通过系列血管造影确定Fogarty球囊扩张和PTCA球囊扩张后即刻的急性管腔增加情况。所有数据均为均值±标准误（SEM）。

结果

21天时，Fogarty球囊损伤处的内膜增生面积高于PTCA球囊损伤处。内膜增生面积分别为0.19±0.02 mm²和0.03±0.01 mm²。损伤后即刻，Fogarty球囊扩张和PTCA球囊扩张后的管腔直径急性增加无差异（分别为0.37±0.03 mm和0.38±0.05 mm）。损伤后第1天，所有节段的内皮细胞剥脱均已完成。Fogarty球囊扩张（67%±7%）和PTCA球囊扩张（74%±9%）引起的中膜坏死无差异。21天时，Fogarty球囊损伤处和PTCA球囊损伤处的内皮细胞覆盖几乎均已完成。Fogarty球囊损伤处的内膜增殖也高于PTCA球囊损伤处。