补片扩大成型术构建猪腹主动脉瘤腔内治疗模型

Open Construction of Experimental Abdominal Aortic Aneurysm Swine Models with Dacron Patch for Evaluating Endovascular Aneurysm Repair Techniques

目的探索使用补片扩大成型技术建立猪腹主动脉瘤模型,验证其作为动脉瘤腔内修复动物模型的可行性。方法实验猪在全身麻醉下接受腹人工血管补片扩大成型术构建腹主动脉瘤模型,随即进行动脉造影,并实施覆膜支架动脉瘤腔内修复术,术后随访3个月复查造影。结果完成腹主动脉瘤模型建立及腔内修复10例,所有模型建立均获得成功,术中测量肾下腹主动脉直径平均为(10.5±0.4)mm;动脉瘤模型最大直径平均为(26.3±3.1)mm,直径平均增加(15.7±3.1)mm;动脉瘤模型建立前、后的动脉直径差异有统计学意义(P<0.001)。除1例因腔内修复时支架遮盖肾动脉于术后24 h死亡,其余实验猪手术过程平稳,术后恢复良好,随访3个月未发生意外死亡,围手术期1个月及术后3个月生存率均为90%。腔内修复发生Ⅱ型内漏1例(10%),随访3个月造影均无内漏。结论全身麻醉下开腹人工血管补片扩大成型技术构建猪腹主动脉瘤模型安全有效,该模型可作为腹主动脉瘤腔内修复的动物模型。

Objective To construct an experimental abdominal aortic aneurysm （AAA） swine model with Dacron patch for evaluating endovascular aneurysm repair （EVAR） technique. Methods The experimental pigs were generally anesthetized for the open procedure of an aneurysm model creation with Dacron and subse- quent arteriography and EVAR with stent graft. Repeat arteriography was performed after 3-month follow- up. Results AAA models were successfully constructed in all l0 experimental pigs. The average aneurysm diame- ter was （26. 3 ±3.1 ） ram, increasing by （ 15.7 ±3.1 ） mm comparing to the primary aorta diameter （ 10. 5 ±0. 4） mm. The aorta diameter before and after the experiment showed significant difference （P 〈0. 001 ）. All the animals were survived after the procedure. One swine died 24 hours after the subsequent EVAR because the covering of both renal arteries by the stent graft. The rest 9 animals survived well after the whole operation and 3- month follow-up. The surviving rates at 1 month and 3 months after the operation were both 90%. One type lI en- doleak （ 10% ） was observed after the EVAR, which disappeared at 3-month follow-up. Conclusions Open construction of experimental AAA swine models with Dacron patch is safe and feasible. The model can be used in the developing new EVAR techniques and implant training.