置入Mercury颈动脉支架的小型猪实验研究  

Mercury carotid stent:mini-pigs experimental study

作　　者：刘加春[1] 王大明[1] 钱江南 李雅国[3] 杨重庆[1] 黄松波[1] 姜学丽[1] 翟乐乐[1] 黄抒伟[3] 姜寿峰[3] 

机构地区：[1]卫生部北京医院神经外科,100730 [2]空军466医院神经内科 [3]浙江医院神经内科

出　　处：《中国脑血管病杂志》2007年第9期405-409,共5页Chinese Journal of Cerebrovascular Diseases

基　　金：国家自然科学基金资助项目(30571975);卫生部临床学科重点项目[卫规财发(2001)321号]

摘　　要：目的评价Mercury颈动脉支架系统的可操作性和组织相容性等。方法选择6头雌性健康广西巴马小型猪,体重为16.6～22.4kg,平均为19.5kg,3～4个月龄。先高脂饲料饲养16周,然后将7枚Mercury颈动脉支架置入6头巴马小型猪的颈动脉内,支架置入后改用普通饲料饲养。支架置入前后,分别进行DSA和血管内超声(IVUS)检查;置入后1周用颈动脉双功能超声判断血管支架内通畅情况,第13周时复查DSA和IVUS,然后取标本进行组织病理学检查。结果①在高脂饲料饲养后2周,动物血浆胆固醇升高达基础值的4.1倍[(2.4±0.3)mmol/L和(9.8±3.8)mmol/L]。此后血浆胆固醇基本稳定在这一高水平。第16周时,DSA显示颈动脉的平均狭窄率为(6.1±4.9)%,IVUS检查见到明显的内膜回声增强。同期预实验巴马小型猪的病理检查可见颈动脉内膜增厚,并有少量泡沫细胞和脂质沉积出现。②支架全部成功置入猪的颈动脉,支架系统具有良好的可操作性。第13周时的DSA和IVUS显示支架内血流通畅。组织病理学检查证明,支架表面已被新生内膜覆盖,新生内膜以平滑肌细胞和胶原纤维为主,支架周围无明显的炎性细胞浸润。结论Mercury颈动脉支架系统具有良好的可操作性,支架本身组织相容性良好。Objective To assess the maneuverability and biocompatibility of Mercury stent system. Methods Six healthy Guangxi Ba-Ma mini-pigs （female, aged 3 - 4 months, weighing 16. 6 - 22.4 kg [mean 19. 5 kg] ） were selected. They were fed a high fat/cholesterol diet for 16 weeks, and then seven Mercury stents were deployed in the carotid arteries of these mini-pigs. After that they were fed with ordinary diet. Digital subtraction angiography （DSA） and intravascular ultrasound （IVUS） were performed respectively before and after the stenting; The in-stent lumen patency was determined by duplex ultrasound （DUS） 1 week after the stenting. Vessels were reexamined by DSA and IVUS at week 13, and then the samples were taken for histopathological examination. Results （1）Two weeks after high fat/cholesterol feeding, the plasma cholesterol of the animals elevated 4. 1 times above the base line （from 2.4 ± 0. 3 mmol/L to 9. 8 ±3.8 mmol/L）, and 14 weeks after this, the plasma cholesterol levels were basically stabled. At week 16, DSA showed that the average stenosis rate was 6. 1 ±4.9%, and IVUS detected obvious echo enhancement of intima. Carotid intima thickening was detected by the pathological examination of preexperimental animal during the same period, and a few foam cells and lipid deposition formed. （2）All the stents were successfully deployed in the carotid arteries of the pigs. The stent system had good maneuverability. At week 13, DAS and IVUS showed that the blood flow was unobstructed in the stents. The histopathological examination demonstrated that the surface of stents had been covered by neointima. The neointima was mainly consist of smooth muscle cell and collogen. There was no obvious inflammatory cell infiltration around the stents. Conclusion Mercury stent system has good maneuverability, and the stent itself has favorable histocompatibility.

关 键 词：支架 颈动脉 猪 

分 类 号：R743.3[医药卫生—神经病学与精神病学]