内膜下血管成形术动物模型的构建

目的建立一种稳定可靠的内膜下血管成形术(subintimal angioplasty,SIA)的动物模型,进而探索术后血管壁有关组成成分的变化规律。方法以巴马猪为实验对象,一组(7只)先建立动脉硬化狭窄模型,另一组(9只)为正常动脉,在颈总动脉施行SIA,在术后不同时间观察造模段动脉的通畅率及病理变化等。结果手术操作成功率为93.8%(15/16)。SIA术后总的通畅率为53.3%(8/15)。病理组织学观察发现SIA术后动脉管壁有新内膜形成,中膜增厚,平滑肌细胞数量增多,较多泡沫细胞出现,胶原纤维及弹力纤维染色范围增大、染色密度增加。超微结构观察提示SIA术后中膜层平滑肌细胞的收缩型与合成型同时存在;细胞外基质中胶原纤维和弹力纤维含量异常丰富。结论①首次成功设计、构建内膜下血管成形术的动物模型。②内膜下血管成形术模型构建术后的病理组织学改变与腔内血管成形术后的变化基本一致。

Establishment of an Animal Model of Subintimal Angioplasty

Objective To establish an animal model of subintimal angioplasty(SIA),and observe the pathologic changes of the components in the treated arteries.Methods 16 Bama mini-pigs were used in this study.Atherosclerotic occlusion model was created in 7 swine.SIA was performed in normal common carotid artery(9 swine)and atherosclerotic common carotid artery(7 swine).The patency rate and vascular pathologic changes were surveyed and examined.Results Technical success rate of SIA performed on swine common carotid arteries was 93.8%(15/16).The total patency rate after SIA was 53.3%(8/15).There was no significant difference in the patency rates after SIA between the groups of normal artery and ASO artery(P=0.43).Comparing to the normal artery,the media of the artery wall was thicker after SIA,and more collagen fibers as well as elastic fibers were present.Smooth muscle cells(SMC)in the media were observed in both contractile and synthesizing appearance.Conclusions(1)An animal model of subintimal angioplasty in Bama swine has been successfully designed and established.The following factors are of great importance to ensure the success:choosing swine as the experimental animal,performing SIA on the common carotid artery,closing the true luminal of the artery with suture,and using anticoagulation drugs after the operation.(2)The pathologic changes after SIA was similar with that after PTA,such as recovered endothelium,SMCs phenotype changed from contracted to synthesis,and increased amount of some extracellular matrix(collagen and elastic fibers).