Aortic dissection occurs when layers of the aortic ,walls are separated by the blood flow through an intimal tear. Dissection of the aorta most frequently originates in the ascending aorta （70%）, followed by the des...Aortic dissection occurs when layers of the aortic ,walls are separated by the blood flow through an intimal tear. Dissection of the aorta most frequently originates in the ascending aorta （70%）, followed by the descending aorta （22%）, the aortic arch （7%） and the abdominal aorta （1/%）.1 The dissection limited to the abdominal aorta is rare.2 An isolated abdominal aortic dissection （IAAD） concomitant with an abdominal aortic aneurysm （AAA） is uncommon. We present here one patient with IAAD and AAA treated by endovascular therapy.展开更多
To provide experimental model for abdominal aortic aneurysm research and to optimize design of stent-graft,the authors established an animal models of prosthetic abdominal aortic aneurysm (PAAA) in dogs,evaluated its ...To provide experimental model for abdominal aortic aneurysm research and to optimize design of stent-graft,the authors established an animal models of prosthetic abdominal aortic aneurysm (PAAA) in dogs,evaluated its biofunction,biocompatibility and renal effect.The PAAA was sutured using aneurysm neck (Φ 6 mm artificial blood vessel) and aneurysm body (Φ 29 and 31mm artificial blood vessel,respectively). Sixteen healthy adult dogs,with weight of 13. 5 ± 0. 66 kg,were randomly divided into 2 groups: group 29 mm and group 31 mm,8 in each group. Infrarenal aortic artery was reconstructed with PAAA to establish abdominal aortic aneurysm (AAA) animal model. Blood coagulation index such as prothrombin time (PT),activated partial thromboplatin time (APTT),thrombin time (TT) and Fibrinogen (Fbg) were detected pre-operation,1,7 and 14 days post-operation,respectively. Blood routine parameters were detected pre-operation 11,3 and 7 days post-operation. Renal function parameters such as blood urea nitrogen (BUN),creatinine (CREA),urea acid (UA) and urea/ creatinine (BU/CREA) were evaluated pre-operation and 30,90,150 days post-operation,respectively. PAAA were removed en bloc to determinine its biofuction and biocompatibility after 5 months of surgery. Kidneys were fixed in neutral buffered formalin solution,pathological slice were conducted to observate pathological changes of kidneys by HE stain.The results are as follows:1. Animal model: The PAAA was implanted to the infrarenal abdominal aortic artery without extensive bleeding after anastomosis. One dog died 2,25 and 127 days post-operation in group 31 mm,respectively,and the overall success rate was 62. 5%. One dog died 7 days post-operation in group 29 mm,the overall success rate was 87. 5%.2. Biofunction and biocompatibility of PAAA: Autopsy showed that there were no abdominal adhesions around the PAAAs,the lumen was patent without blood clots,there were no bleeding in PAAAs in two groups. Biocompatibility was poor because the outer layer of PAAA was enclosed by tissues,which was easy to strip,in group 31 mm. Excellent biocompatibility was proved by vascular endothelial cells growth in the inner layer of PAAA in group 29 mm.3. Coagulation examination: ATPP reduced significantly 1 day post-operation,and returned to normal after 7 days;there was no significant difference on TT in two groups. Fbg increased significantly 1 day post-operation (3. 16 ± 0. 56g/L,P<0. 05),and returned to normal after 7 days; PT and INR have no significant difference in group 29 mm. Value of PT and INR was 7. 92 ± 0. 57s and 0. 655 ± 0. 49,respectively,which reduced significantly compared with base value (P<0. 05),and returned to normal after 7 days; Fbg increased extremely 1 day post-operation (3. 28 ± 0. 49 g /L) (P<0. 01),which still increased significantly after 7 and 14 days in group 31 mm.4. Blood routine examination: Red blood cell count (RBC) and hemoglobin (HGB) reduced significantly 1 and 3days post-operation (P<0. 05); white blood cell count (WBC) and intermediate cell rate (MID%) increased extremely 1 day post-operation; there was no significant change in platelet count in group 29 mm. Mean corpuscular volume (MCV),RBC,HGB reduced significantly 1 and 3 days post-operation; WBC and MID% increased extremely 1 day after surgery; platelet (PLT),thrombocytocrit (PCT%) and platelet distribution width (PDW%) increased significantly1 day post-operation in group 31 mm.5. Renal function: BUN was 3. 995 ± 0. 36 mmol/L,which reduced extremely (P<0. 01),CREA was 104. 5 ±13. 85 μmol/L,which increased significantly (P<0. 05) after 150 days. BU/CREA reduced 90 and 150 days post-operation; UA reduced significantly or extremely 30,90 and 150 days post-operation (P<0. 05,P<0. 01),Its' values were 309. 61 ± 40. 8 μmol/L,160. 26 ± 28. 73 μmol/L and 23. 69 ± 12. 66 μmol/L,respectively in group 29 mm.In group 31 mm,BUN were 5. 51 ± 0. 43 mmol/L and 5. 36 ± 0. 32 mmol/L,which reduced significantly (P <0. 05); BU/CREA reduced significantly (P<0. 05),CREA were 106. 83 ± 7. 0 μmol/L、113. 17 ± 9. 79 μmol/L (P< 0. 05),which increased significantly compared with base values (P<0. 05) 90 and 150 days post-operation. UA reduced significantly or extremely 30,90 and 150 days post-operation (P<0. 05,P<0. 01),its' values were 303. 17 ±39. 2 μmol/L,144. 17. 26 ± 31. 06 μmol/L and 20. 83 ± 11. 52 μmol/L,respectively.6. Pathologic observation of kidney: Glomerular atrophy and granular degeneration in renal tubule with luminal narrowing was observed under microscope. Red thrombosis could be seen in part of renal tubule and renal glomerulus.Animal model of PAAA in dogs was successfully established. Biofunction and biocompatibility of PAAA in group 29mm is better than that of group 31mm. There were great changes in renal function,and obvious pathological changes appeared on kidney post-operation.展开更多
文摘Aortic dissection occurs when layers of the aortic ,walls are separated by the blood flow through an intimal tear. Dissection of the aorta most frequently originates in the ascending aorta （70%）, followed by the descending aorta （22%）, the aortic arch （7%） and the abdominal aorta （1/%）.1 The dissection limited to the abdominal aorta is rare.2 An isolated abdominal aortic dissection （IAAD） concomitant with an abdominal aortic aneurysm （AAA） is uncommon. We present here one patient with IAAD and AAA treated by endovascular therapy.
文摘To provide experimental model for abdominal aortic aneurysm research and to optimize design of stent-graft,the authors established an animal models of prosthetic abdominal aortic aneurysm (PAAA) in dogs,evaluated its biofunction,biocompatibility and renal effect.The PAAA was sutured using aneurysm neck (Φ 6 mm artificial blood vessel) and aneurysm body (Φ 29 and 31mm artificial blood vessel,respectively). Sixteen healthy adult dogs,with weight of 13. 5 ± 0. 66 kg,were randomly divided into 2 groups: group 29 mm and group 31 mm,8 in each group. Infrarenal aortic artery was reconstructed with PAAA to establish abdominal aortic aneurysm (AAA) animal model. Blood coagulation index such as prothrombin time (PT),activated partial thromboplatin time (APTT),thrombin time (TT) and Fibrinogen (Fbg) were detected pre-operation,1,7 and 14 days post-operation,respectively. Blood routine parameters were detected pre-operation 11,3 and 7 days post-operation. Renal function parameters such as blood urea nitrogen (BUN),creatinine (CREA),urea acid (UA) and urea/ creatinine (BU/CREA) were evaluated pre-operation and 30,90,150 days post-operation,respectively. PAAA were removed en bloc to determinine its biofuction and biocompatibility after 5 months of surgery. Kidneys were fixed in neutral buffered formalin solution,pathological slice were conducted to observate pathological changes of kidneys by HE stain.The results are as follows:1. Animal model: The PAAA was implanted to the infrarenal abdominal aortic artery without extensive bleeding after anastomosis. One dog died 2,25 and 127 days post-operation in group 31 mm,respectively,and the overall success rate was 62. 5%. One dog died 7 days post-operation in group 29 mm,the overall success rate was 87. 5%.2. Biofunction and biocompatibility of PAAA: Autopsy showed that there were no abdominal adhesions around the PAAAs,the lumen was patent without blood clots,there were no bleeding in PAAAs in two groups. Biocompatibility was poor because the outer layer of PAAA was enclosed by tissues,which was easy to strip,in group 31 mm. Excellent biocompatibility was proved by vascular endothelial cells growth in the inner layer of PAAA in group 29 mm.3. Coagulation examination: ATPP reduced significantly 1 day post-operation,and returned to normal after 7 days;there was no significant difference on TT in two groups. Fbg increased significantly 1 day post-operation (3. 16 ± 0. 56g/L,P<0. 05),and returned to normal after 7 days; PT and INR have no significant difference in group 29 mm. Value of PT and INR was 7. 92 ± 0. 57s and 0. 655 ± 0. 49,respectively,which reduced significantly compared with base value (P<0. 05),and returned to normal after 7 days; Fbg increased extremely 1 day post-operation (3. 28 ± 0. 49 g /L) (P<0. 01),which still increased significantly after 7 and 14 days in group 31 mm.4. Blood routine examination: Red blood cell count (RBC) and hemoglobin (HGB) reduced significantly 1 and 3days post-operation (P<0. 05); white blood cell count (WBC) and intermediate cell rate (MID%) increased extremely 1 day post-operation; there was no significant change in platelet count in group 29 mm. Mean corpuscular volume (MCV),RBC,HGB reduced significantly 1 and 3 days post-operation; WBC and MID% increased extremely 1 day after surgery; platelet (PLT),thrombocytocrit (PCT%) and platelet distribution width (PDW%) increased significantly1 day post-operation in group 31 mm.5. Renal function: BUN was 3. 995 ± 0. 36 mmol/L,which reduced extremely (P<0. 01),CREA was 104. 5 ±13. 85 μmol/L,which increased significantly (P<0. 05) after 150 days. BU/CREA reduced 90 and 150 days post-operation; UA reduced significantly or extremely 30,90 and 150 days post-operation (P<0. 05,P<0. 01),Its' values were 309. 61 ± 40. 8 μmol/L,160. 26 ± 28. 73 μmol/L and 23. 69 ± 12. 66 μmol/L,respectively in group 29 mm.In group 31 mm,BUN were 5. 51 ± 0. 43 mmol/L and 5. 36 ± 0. 32 mmol/L,which reduced significantly (P <0. 05); BU/CREA reduced significantly (P<0. 05),CREA were 106. 83 ± 7. 0 μmol/L、113. 17 ± 9. 79 μmol/L (P< 0. 05),which increased significantly compared with base values (P<0. 05) 90 and 150 days post-operation. UA reduced significantly or extremely 30,90 and 150 days post-operation (P<0. 05,P<0. 01),its' values were 303. 17 ±39. 2 μmol/L,144. 17. 26 ± 31. 06 μmol/L and 20. 83 ± 11. 52 μmol/L,respectively.6. Pathologic observation of kidney: Glomerular atrophy and granular degeneration in renal tubule with luminal narrowing was observed under microscope. Red thrombosis could be seen in part of renal tubule and renal glomerulus.Animal model of PAAA in dogs was successfully established. Biofunction and biocompatibility of PAAA in group 29mm is better than that of group 31mm. There were great changes in renal function,and obvious pathological changes appeared on kidney post-operation.
