经椎-基底动脉插管建脑梗死模型:beagle犬脑动脉数字减影血管造影表现

Establishment of cerebral infarction models in beagle dogs by superselective catheterization via the vertebral basilar artery: cerebral arterial digital subtraction angiography manifestation

背景:因犬颈内动脉入颅之前弯曲度大,呈螺旋形,难以超选择插管,目前犬脑梗死模型往往从颈内动脉灌入自体血栓、明胶海绵等栓塞物质,这种方法建立的模型与人类的脑梗死发病机制相差甚远。椎动脉造影可以清晰显示大脑血管结构,可能会为犬急性脑梗死模型的建立提供新的条件。目的:探索用介入技术经椎-基底动脉途经超选择插管制作beagle犬急性脑梗死模型的可行性。方法:将5只beagle犬分为血栓组(n=3)与对照组(n=2)。血栓组犬经股动脉穿刺插管分别行主动脉弓、颈总动脉与椎动脉数字减影血管造影检查,将2.7F微导管经椎-基底动脉超选择插管至左侧后交通动脉与颈内动脉交通处,注入1条自体血栓条。对照组犬注入适量对比剂。结果与结论:5只犬左、右侧颈总动脉造影可清晰显示粗大的颈外动脉(10/10)及其分支,但只有5条(5/10)颈内动脉在颈总动脉造影时隐约可见显影。颈内动脉管径较细并形成一螺旋形血管袢。左、右椎动脉(10/10)造影可清晰显示椎-基底动脉、"Willis"环、双侧大脑后动脉、大脑中动脉和大脑前动脉。均能将微导管经椎-基底动脉超选择插管至左侧后交通动脉与颈内动脉交通处。磁共振弥散加权成像显示,造模后3 h与6 h血栓组犬左侧大脑颞叶出现局部高信号。说明用椎动脉造影的方法选择经椎-基底动脉途径将微导管超选择插管至beagle犬的左侧大脑中动脉行自体血栓栓塞可成功制作beagle犬急性脑梗死模型,这为选择插管精确栓死beagle犬大脑中动脉提供新方法。

BACKGROUND： It is difficult to perform superselective catheterization of the internal carotid artery in dogs because of the large bending and spiral shape of the interal carotid artery before entering into the skull. At present, the dog models of cerebral infarction established by injecting autologous blood clots and gelatin sponge via the internal carotid artery are far from the perspective of pathological mechanism of human patients with cerebral infarction. Aortography can visualize the structure of cerebral vessels and is likely to provide a new condition for the establishment of dog models of acute cerebral infarction. OBJECTIVE： To explore the feasibility of establishing cerebral infarction models in beagle dogs by superselective catheterization via the vertebral basilar artery. METHODS： Five beagle dogs were divided into thrombus group（n=3） and control group（n=2）. The beagle dogs in the thrombus group were subjected to digital subtraction angiography of the aortic arch, bilateral common carotid arteries and vertebral arteries in addition to femoral arterial catheterization. The 2.7F micro-catheter was inserted into the convergence zone of the left posterior communicating artery and the internal carotid artery through the vertebrobasilar artery. An autologous blood clot was injected into the convergence zone. The dogs in the control group were injected with appropriate amount of contrast medium. RESULTS AND CONCLUSIONS： Through angiography of the left and right common carotid artery of five dogs, thick external carotid arteries（10/10） and their branches were clearly displayed, however, only five（5/10） internal carotid arteries were dimly present. A spiral vascular loop formed in the internal carotid artery with a small-sized diameter. Through antiography of the left and right vertebral arteries（10/10） angiography, vertebral basilar artery, the circle of ＂Willis＂, bilateral posterior cerebral arteries, bilateral middle cerebral arteries and bilateral anterior cerebral arteries were clearly displayed, all these contribute to insertion of microcatheter into the convergence zone of the left posterior communicating artery and the internal carotid artery through the vertebrobasilar artery. High signal intensity of the left temporal lobe was shown on 3-hour and 6-hour diffusion weighted images.The results demonstrate that the beagle dog models of acute cerebral infarction can be successfully established by injecting autologous blood clots into the left middle cerebral artery through a microcathter inserted via the vertebrobasilar artery, which provides a new method of precisely occluding the middle cerebral artery of beagle dogs by catheterization.