新型球囊扩张支架治疗肺动脉狭窄的动物实验研究  

A Novel Balloon-expandable Stent Implanted in a Swine Model of Congenital Pulmonary Artery Stenosis

作　　者：陈泽锐[1] 潘湘斌[1] 孟强[1] 吴信[1] 王德[1] 花中东[1] 李守军[1] 

机构地区：[1]北京协和医学院中国医学科学院阜外心血管病医院小儿心脏外科中心,北京100037

出　　处：《中国胸心血管外科临床杂志》2011年第6期543-548,共6页Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

摘　　要：目的评价国产钴铬合金支架经右心室流出道植入术治疗肺动脉狭窄的有效性及安全性。方法将8只小型猪分别接受左侧第3肋间开胸,取自体心包条环缩左肺动脉至原始直径的30%～40%,于术后1个月正中开胸,在X射线引导下经右心室流出道植入球囊扩张支架,并应用心血管造影检查评价肺动脉支架植入后的位置和血流动力学情况。支架植入术后1个月和3个月分别处死4只动物,取标本行大体、光学显微镜和扫描电子显微镜检查。结果8只小型猪左肺动脉环缩模型均在成功建立后植入支架,支架植入后左肺动脉内径较环缩后增加(15.6±0.4mm vs.6.4±0.2mm,P<0.01),而跨环缩狭窄段收缩压差则较植入前下降[34.5(23～52)mm Hg vs.6.0(1～20)mm Hg,P=0.012];随访期间8只小型猪均未出现支架脱落、动脉夹层、血管破裂等并发症;扫描电子显微镜显示:所有小型猪肺动脉支架贴壁及内皮化良好,未出现支架腐蚀、断裂,其中有2只随访3个月后出现支架内新生内膜增生,但并未导致血流动力学显著改变。结论在动物肺动脉狭窄模型中植入新型球囊扩张支架是安全有效的。Objectives To evaluate the effectiveness of implanting a balloon-expandable stent into a stenotic pulmonary artery in a swine model. Methods In eight swine, a pulmonary artery stenosis model was created by banding the left pulmonary artery to 30%-40% of its original diameter. The animals underwent right heart catheterization and angiography four weeks postoperatively, and Cobalt-Chromium alloy stents were implanted through the right ventricular outflow tract. Four animals were sacrificed at 1 month, and the other four at 3 months after stenting. They were then microscopically evaluated for histologic changes. Results The lumen diameter increased from 6.4±0.2 mm to 15. 6±0：4 mm （P〈0.01）, while the gradient decreased from median （range） 34.5 （23-52） mm Hg to 6.0 （1-20） mm Hg （P= 0. 012） following stenting. No stents dislodged, and there were no significant vessel tears or ruptures. Stents with neointimal proliferation were observed by scanning electron microscope in 2 animals sacrificed at 3 months; however, there was no significant hemodynamic difference between the two animals.

关 键 词：支架 球囊扩张 环缩 肺动脉狭窄 

分 类 号：R654.2[医药卫生—外科学]