建立椎动脉急性血栓栓塞犬模型:微球囊导管临时隔截取栓  

Establishment of acute vertebral artery thrombosis models in dogs: micro-balloon catheter temporary isolation for embolectomy

作　　者：韦文姜[1] 肖承江[1] 李立恒[1] 江桂华[2] 

机构地区：[1]广东省第二人民医院介入科,广东省广州市510317 [2]广东省第二人民医院影像科,广东省广州市510317

出　　处：《中国组织工程研究》2015年第18期2849-2855,共7页Chinese Journal of Tissue Engineering Research

基　　金：广东省高科技基金资助项目(2012B031800477)~~

摘　　要：背景:为了避免机械取栓术中血栓脱落造成远端栓塞,作者以期运用微球囊临时隔截的方法来建立防止血栓脱落的保护装置。目的:探讨采用微球囊临时阻断动脉血流并隔截栓塞段保护下行机械碎栓、吸栓联合溶栓治疗超急性脑梗死的安全性和可行性。方法:Beagle犬10只在全身麻醉下经股动脉插管将微球囊导管送至优势侧椎动脉内并充盈球囊临时阻断血流,经微导管注入自体血栓建立椎动脉血栓栓塞模型,按治疗方法均分为2组,对照组采用单纯支架取栓,实验组采用微球囊导管临时阻断血流并隔截靶动脉后行机械碎栓吸栓联合药物溶栓。两组治疗后均行数字减影血管造影复查栓塞椎动脉再通状况;采用血栓性脑缺血血流分级进行血流动力学评估。造模前及取栓后12 h行磁共振弥散加权成像。建模后12 h行核磁共振成像检查后处死动物行病理检查,统计两组血管再通成功率及并发症。结果与结论:10只beagle犬的优势侧椎动脉均成功出现血栓栓塞。对照组中2只犬椎动脉完全再通,3只犬椎动脉部分再通,其中1只犬椎-基底动脉与颅内动脉中可见多处小点状充盈缺损,颅内动脉显影差,对比剂返流,建模后12 h磁共振弥散加权成像示左侧颞顶叶稍高信号影,病理检查示左侧大脑颞叶动脉腔内见血栓形成。实验组中5只犬椎动脉均完全再通,未见脑梗死。实验组血管再通率高于对照组(P<0.05)。结果证实,在急性脑动脉栓塞血管再通中采用微球囊导管临时阻断血流并隔截靶动脉保护下机械碎栓、吸栓联合尿激酶溶栓,可有效防止小栓子脱落栓塞远端动脉,安全有效。BACKGROUND：In order to avoid distal arterial embolism fol owing mechanical thrombectomy, micro-bal oon catheter temporary isolation is applied to prevent thrombus shedding. OBJECTIVE：To investigate the safety and feasibility of adopting the micro-bal oon catheter technique in treatment of the hyperacute cerebral infarction. The micro-bal oon catheter technique can temporarily block the artery blood flow and isolate the embolism location fol owing mechanical thrombectomy and aspiration combined with thrombolysis. METHODS：Ten beagle dogs were included in this study. Under general anesthesia, the micro-bal oon catheter＆nbsp;was delivered to the dominant vertebral artery through the femoral artery in al the dogs and it was fil ed and temporarily blocked the blood flow. Then the autologous thrombus was injected through the micro-catheter into proximal vertebral artery to make a thrombosis model. Al the dogs were equal y divided into two groups according to the embolectomy method：control group （receiving pure stent embolectomy, n=5） and experimental group （n=5）. The experiment group was disrupted and aspirated thrombus combined with the drug thrombolysis after temporarily blocking out the blood flow and isolating the target artery by micro-bal oon catheter technique. After treatment, two groups underwent digital subtraction angiography to review the vertebral artery recanalization after different embolectomy methods. The hemodynamic status was evaluated through the thrombolysis in cerebral ischemia grade. Al the dogs were scanned with magnetic resonance diffusion weighted imaging before modeling and at 12 hours after the thrombectomy. The animals were kil ed to perform pathological examination after magnetic resonance diffusion weighted imaging （12 hours after the thrombectomy）. The vessel recanalization rates and complications were calculated in the two groups. RESULTS AND CONCLUSION：The thromboembolism model was successful y established in the dominant vertebral artery of al the 10 beagle d

关 键 词：实验动物 脑及脊髓损伤模型 球囊导管 犬 椎动脉 模型 磁共振 数字减影血管造影 血栓 脑动脉栓塞 机械碎栓 支架取栓 

分 类 号：R318[医药卫生—生物医学工程]