异物创伤性动脉瘤犬模型构建的初步探讨

Initial study on modeling of traumatic aneurysm with foreign body in canine

目的:建立异物创伤性动脉瘤的犬模型,为伴血管损伤软组织异物一站式介入治疗研究提供动物模型。方法:随机选取2年龄的健康雄性比格犬7只,分为颈动脉瘤造模5只和未造模2只,造模于右侧颈动脉共5支血管为研究组,其左侧颈动脉及未造模2只犬两侧颈动脉共9支血管为对照组。研究组将长约15～20 mm的离断颈静脉剪开、缝合于同侧颈总动脉前璧上,以弯型断针穿破静脉片及动脉前壁,静脉片-动脉壁间腔搏动性充盈且无缝缘渗漏后,断针部分留存于该间腔甚或动脉腔内,逐层缝合手术区域组织。然后,经皮经股动脉插管选择性颈总动脉进行数字减影血管造影(DSA)。对照组颈动脉仅于其旁以缝针经皮扎伤软组织且无明显出血及血肿。术前、术后行颈部CT血管成像(CTA)和数字放射摄影(DR)检查与评估。结果:研究组5支右侧颈动脉断针创伤性动脉瘤均成功造模,技术成功率100%;DSA清晰显示动脉破口、动脉瘤状动脉突起及断针异物,载瘤动脉局部轻度痉挛及狭窄,创伤性动脉瘤模型的瘤颈宽度为(2.1±1.3)mm,瘤体宽(9.7±1.1)mm,瘤体高(4.2±1.7)mm;CTA不如DSA显示效果佳。对照组9支颈动脉均正常。结论:采用颈静脉片侧-侧吻合于同侧颈动脉前壁上并以断针穿破静、动脉壁且断针部分留置于其间的技术与方法,成功构建了异物创伤性动脉瘤犬模型。

Objective： To research modeling of traumatic aneurysm with foreign body in canine carotid artery, and to provide an animal model for one-stop interventional treatment of soft tissue foreign body with vascular injury. Materials and Methods： Seven healthy male beagles aged 2 years were randomly divided into two groups： 5 in research group and 2 in control group. In research group ,local jugular vein about 15-20 mm in length was cut off and sewn into the anterior wall of the ipsilateral carotid artery with 6-0 suture . The curved suture needle was then worn through the vein and artery, and kept partially in them even in the artery cavity. T he surgical area tissues were sutured layer by layer after the a rtificial cavity between the vein and arterial walls p ulsating protrusion and n o leakage from the s titched edge. Finally, selective common carotid artery digital subtraction angiography （DSA） underwent by p ercutaneous transfemoral artery to furthe r confirm the aneurysm model. In control group, only soft tissue s surrounding the common carotid artery were percutaneously injured using a needle without significant bleeding and hematoma. Digital radiographs and CT angiography of neck performed before and after the modeling operation. Results： Five traumatic aneurysm s with foreign body of b roken needle were made successfully in canine common carotid artery, and the technical success rate of establishment traumatic aneurysm with foreign body was 100%. DSA clearly showed the arterial rupture, aneurysm, broken needle , and mild v asospasm and stenosis of local parent artery, which showed poorly on CTA . No abnormal findings were showed in common carotid arteries in control group. Conclusion： The canine model of foreign body within traumatic aneurysm was successfully constructed by using the method of a residual broken needle break ing through the anastomotic vessel wall after a side-to-side？anastomosis to the carotid artery wall of with a piece of the ipsilateral jugular vein.