兔腹主动脉分叉双支架术模型的建立

Establishment of a rabbit model of double stenting in the aortoiliac bifurcation

目的建立兔腹主动脉分叉双支架术模型。方法雄性新西兰兔5只(体质量3.0~3.5 kg),麻醉消毒后,经颈动脉途径于腹主动脉-髂动脉血管分叉处采用边支支架微突T支架技术(T-stenting and small protrusion,TAP)实施双支架植入术,利用数字减影血管造影(digital subtraction angi-ography,DSA)、血管内超声(intravascular ultrasound,IVUS)和显微CT扫描(micro computed tomography,micro-CT)进行术后即刻评价及术后6个月复查。结果可通过兔颈动脉放置6F鞘管,于腹主动脉分叉处成功实施TAP双支架术,术后即刻DSA提示支架位置满意,血流TIMI 3级,IVUS提示支架贴壁良好,术后6个月复查DSA提示无支架内再狭窄及血栓形成,血流TIMI 3级,IVUS提示支架贴壁良好,无支架内再狭窄,micro-CT可见边支开口处支架覆盖完全,无支架内血栓,右侧髂动脉支架下缘微突入腹主动脉管腔[(0.49±0.08)mm]。结论成功建立了兔腹主动脉分叉双支架术模型,为冠脉分叉病变的临床前期研究提供了依据。

Objective To establish a rabbit model of double stenting in the aortoiliac bifurcation. Methods Five normal New Zealand rabbits were anesthetized for double stent placement in the aortoiliac bifurcation via the left carotid artery using T-stenting and small protrusion （TAP） technique. The immediate and follow-up outcomes at 6 months after stent placement were evaluated with digital subtraction angiography （ DSA）, intravascular ultrasound （IVUS） and micro-computed tomography （micro-CT）. Results A 6F artery sheath was placed in the left carotid artery, and IVUS showed that the diameter of the abdominal aorta and the iliac artery was 3.0 and 2.5 mm, respectively. TAP technique was successfully performed for double stenting in the aortoiliac bifurcation. DSA and IVUS showed optimal stent apposition with a Thrombolysis In Myocardial Infarction （TIMI） flow grade 3. At 6 months after stent placement, DSA showed a TIMI flow grade 3 without in-stent thrombus or restenosis, and IVUS showed optimal stent apposition without restenosis. Micro- CT revealed a complete coverage of the side-branch ostium by the stent, whose lower edges slightly protruded into the abdominal aortic lumen by 0.49 ± 0. （38 mm without in-stent thrombosis. Conclusion We successfully established a rabbit model of double stenting in the aortoiliac bifurcation for pre-clinical study of coronary bifurcation lesions.