经皮腔内血管成形术机理的动物实验研究

THE MECHANISM OF PERCUTANEOUS TRANSLUMINAL ANGIOPLASTYIU——ANIKIAL EXPERIMENT

利用新西兰纯系雄性白兔33只制作成髂动脉粥样硬化模型,对狭窄血管进行腔内扩张成形术。22只兔被成功扩张的27支血管,扩张前后管径相比较,差异非常显著(P<0.001)。生理压灌注固定后观察扩张段血管内膜撕裂、斑块破碎、内膜与中膜分离、中外膜向外伸展膨出等组织形态学改变。证实文献报道的关于内膜撕裂、局部动脉瘤形成是经皮腔内血管成形术的机理。未发现斑块压缩或重分布。

Experimental athersclerosis was developed in both iliac arteries of 33 New Zealand male white rab-bits. Transluminal angioplasty was performed on 27 vessels in 22 rabbits to observe whether athero-sclerotic material was compressed. It was shown that angioplasty reduced the iliac narrowing in all ani-mals studied. Iliac arteries before and after dilating disclosed significant differences in luminal diame-ter (P<0.001). Morphometric analysis of histologic sections of physiologic pressure-perfused rabbitatherosclerotic arteries disclose that dilated areas demonstrated marked intimal splitting, plaque separa-ting from underlying media, and media and adventitia stretching. Thus, these enlarged the artery lumenand resulted in localized aneurysm formation. There was no evidence of plaque compression or remo-deling of atheromatous material in this study. These findings provided a possible mechanism for percu-taneous transluminal coronary angioplasty(PTCA).