介入技术结合手术建立简易绵羊脑动静脉畸形模型的初步研究

Construction simplified arteriovenous malformation animal model by interventional techniques and operation

目的 应用介入技术和手术 ,无须手术吻合 ,制作简易的急性脑动静脉畸形动物模型。方法 两个 6F导管鞘 ,分别插入绵羊一侧颈总动脉和颈外静脉 ,一段输血管连通两个导管鞘 ,形成类似手术吻合的颈动静脉瘘 ,夹闭颈总动脉近心端 ,夹闭或不夹闭颈外静脉远心端 ;连接前和连接后分别做对侧颈动脉造影 ,以证实血流的方向。结果 6只绵羊 ,全部形成以造瘘对侧颌内动脉为“供血动脉” ,以两侧颅底微血管网为“畸形团” ,造瘘侧颌内动脉为“引流静脉”的AVM模型。结论 以介入技术为主要方法建立动静脉瘘 ,效果相当于手术 ,其优点为节约时间 ,操作简单 ,可应用于急性AVM的实验研究 。

Objective To establish a simplified arteriovenous malformation(AVM) animal model using interventional techniques and operation instead of operative carotid jugular vein anastomosis. Methods After exposing carotid and external jugular vein by operation, two 6F catheter sheath were inserted into common carotid artery and the ipsilateral external jugular vein respectively in 6 sheeps; The two sheaths were connected by blood transfusion pipe to establish an arteriovenous fistula resembling that by operative anastomosis, clipping the proximal common artery below puncture is site and/or not clipping the distal external jugular vein above puncture site were performed. Cerebral angiograph from the contralateral carotid artery was performed before and immediately after connecting to determine the direction of bllod flow. Results An angiographic appearance simulating an AVM was found in all the sheep. The anastomosis branches of internal maxillary artery functioned as feeding artery, the bilateral rete mirabile represented the nidus and the contralateral internal maxillary artery and carotid and jugulal vein as draning vein. Conclusions Establishment of an AVM animal model by interventional technique in sheep was easy, simple and less time costing, the effect was reliable as by operation anastomosis method. The model is suitable for the acute AVM research. It is more suitable for training of interventional staff than reported animal model.