小型猪颈动脉支架和球囊扩张的血管内超声研究

Intravascular ultrasound study on carotid stent and balloon angioplasty of swines

目的应用血管内超声（IVUS）探讨小型猪颈动脉支架和球囊扩张后再狭窄机制。方法12只中国广西巴马小型猪高脂饲养后随机分两组，每组6只。一组于左侧颈动脉置人7枚支架，另一组于左侧颈动脉行球囊扩张，并于术前、术后即刻、术后13周进行一系列IVUS和DSA检查。结果13周后IVUS显示支架组和球囊组血管面积分别狭窄（18．31±7．79）％和（37．28±7．89）％。支架内再狭窄与支架内膜增生明显相关（r=0．897，P〈0．05）；球囊扩张后再狭窄与外弹力膜面积减少显著相关（r=0．856，P〈0．05）。结论支架再狭窄与血管内膜过度增生有关，球囊扩张再狭窄与外弹力膜减少有关。

Objective To investigate the mechanism of restenosis after carotid stent and balloon angioplasty for the Guangxi swines by intravascular uhrasound（IVUS）. Methods Twelve Guangxi swines fed by a high cholesterol diet were randomly divided into two groups. Seven stents were implanted in the left carotid artery of six swines in the first group, and balloon angioplasty was performed in the left carotid artery of swines in the other group. Digital subtraction angiography （DSA） and IVUS were conducted respectively before and after the intervention and in the 13th week. Results IVUS found that the percentage of area stenosis in stent group was （18.31 ± 7.79）% and in balloon group （37.28± 7.89）%in the 13th week. The percentage of area restenosis in stent was obviously related to neointimal hyperplasia （r = 0. 897, P 〈0.05）, the percentage of area restenosis due to balloon angioplasty was markedly related to area decrease of external elastic lamina （ r = 0. 856, P〈0. （15）. Conclusions The restenosis in stem was related to intimal hyperplasia of blood vessel, and restenosis after balloon angioplasty had some connection with area decrease of external elastic lamina.