Development of a Porcine Model of Arteriovenous Fistula Venous Stenosis Treated with Percutaneous Transluminal Angioplasty.

IF 2.6 3区医学 Q2 PERIPHERAL VASCULAR DISEASE

Journal of Vascular and Interventional Radiology Pub Date : 2024-10-24 DOI:10.1016/j.jvir.2024.10.020

Prabh G Singh, Sreenivasulu Kilari, Ahmed S Negm, Joanne M Pedersen, Dan R Montonye, Kiaran P McGee, Jeremy D Collins, Sanjay Misra

{"title":"Development of a Porcine Model of Arteriovenous Fistula Venous Stenosis Treated with Percutaneous Transluminal Angioplasty.","authors":"Prabh G Singh, Sreenivasulu Kilari, Ahmed S Negm, Joanne M Pedersen, Dan R Montonye, Kiaran P McGee, Jeremy D Collins, Sanjay Misra","doi":"10.1016/j.jvir.2024.10.020","DOIUrl":null,"url":null,"abstract":"Purpose: To develop a porcine model for arteriovenous fistula (AVF) venous stenosis treated with percutaneous transluminal angioplasty (PTA) and compare outcomes of plain balloon angioplasty (POBA) to IN.PACT paclitaxel drug-coated balloons (DCB).Materials and methods: Twelve castrated male Yorkshire pigs (4-5 months, 35-45kg) underwent renal artery embolization to induce chronic kidney disease (CKD). Twenty-eight days later, AVF was created by anastomosing the left external jugular vein to left common carotid artery. The pigs were divided into a pilot group (n=6) for optimizing the AVF technique (euthanized at day 4) and a definitive group (n=6) for validating PTA outcomes (euthanized at day 42). Stenosis developed at juxta-anastomosis 28 days later and was treated with POBA [pilot group (n=6), definitive group (n=3)] or DCB [definitive group only (n=3)]. Definitive group underwent biweekly 4D Flow MRI scans.Results: All animals developed CKD, with significant increases in BUN (median increase: 2.6 to 3.2 mmol/L, P<0.001) and creatinine (median increase: 100 to 187 μmol/L, P<0.001). In the pilot group, one animal had an infected fistula, and AVF patency was 1/5. In the definitive group, the patency was 5/6 because the AVF technique was modified by resecting the sternomastoid muscle and increasing the spatulation. At day 42 post PTA, DCB treated AVF outflow vein showed increasing blood flow compared to POBA (DCB 209.8 ± 64.42 mm2 vs POBA 170.9 ± 95.52 mm2 p = 0.934).Conclusions: A porcine model of AVF venous stenosis treated with PTA was developed, with blood flow trends favoring DCB over POBA.","PeriodicalId":49962,"journal":{"name":"Journal of Vascular and Interventional Radiology","volume":" ","pages":""},"PeriodicalIF":2.6000,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Vascular and Interventional Radiology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.jvir.2024.10.020","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"PERIPHERAL VASCULAR DISEASE","Score":null,"Total":0}

引用次数: 0

Abstract

Purpose: To develop a porcine model for arteriovenous fistula (AVF) venous stenosis treated with percutaneous transluminal angioplasty (PTA) and compare outcomes of plain balloon angioplasty (POBA) to IN.PACT paclitaxel drug-coated balloons (DCB).

Materials and methods: Twelve castrated male Yorkshire pigs (4-5 months, 35-45kg) underwent renal artery embolization to induce chronic kidney disease (CKD). Twenty-eight days later, AVF was created by anastomosing the left external jugular vein to left common carotid artery. The pigs were divided into a pilot group (n=6) for optimizing the AVF technique (euthanized at day 4) and a definitive group (n=6) for validating PTA outcomes (euthanized at day 42). Stenosis developed at juxta-anastomosis 28 days later and was treated with POBA [pilot group (n=6), definitive group (n=3)] or DCB [definitive group only (n=3)]. Definitive group underwent biweekly 4D Flow MRI scans.

Results: All animals developed CKD, with significant increases in BUN (median increase: 2.6 to 3.2 mmol/L, P<0.001) and creatinine (median increase: 100 to 187 μmol/L, P<0.001). In the pilot group, one animal had an infected fistula, and AVF patency was 1/5. In the definitive group, the patency was 5/6 because the AVF technique was modified by resecting the sternomastoid muscle and increasing the spatulation. At day 42 post PTA, DCB treated AVF outflow vein showed increasing blood flow compared to POBA (DCB 209.8 ± 64.42 mm² vs POBA 170.9 ± 95.52 mm² p = 0.934).

Conclusions: A porcine model of AVF venous stenosis treated with PTA was developed, with blood flow trends favoring DCB over POBA.

查看原文本刊更多论文

利用经皮腔内血管成形术治疗动静脉瘘静脉狭窄的猪模型的开发。

目的：建立用经皮腔内血管成形术（PTA）治疗动静脉瘘（AVF）静脉狭窄的猪模型，并比较普通球囊血管成形术（POBA）和 IN.PACT 紫杉醇药物涂层球囊（DCB）的疗效：12 头阉割的雄性约克夏猪（4-5 个月，35-45 千克）接受肾动脉栓塞以诱发慢性肾病（CKD）。28 天后，通过吻合左侧颈外静脉和左侧颈总动脉创建 AVF。猪被分为试验组（6 头）和最终组（6 头），试验组用于优化 AVF 技术（第 4 天安乐死），最终组用于验证 PTA 结果（第 42 天安乐死）。28 天后，并行吻合处出现狭窄，采用 POBA [试验组（n=6）、确定组（n=3）] 或 DCB [仅确定组（n=3）] 治疗。确定组每两周进行一次 4D 流式磁共振成像扫描：结果：所有动物都出现了慢性肾功能衰竭，BUN 显著增加（中位增加：2.6 至 3.2 mmol/L，P2 vs POBA 170.9 ± 95.52 mm2 p = 0.934）：结论：建立了一个用 PTA 治疗 AVF 静脉狭窄的猪模型，其血流趋势是 DCB 优于 POBA。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Journal of Vascular and Interventional Radiology 医学-核医学

CiteScore

4.30

自引率

10.30%

发文量

942

审稿时长

90 days

期刊介绍： JVIR, published continuously since 1990, is an international, monthly peer-reviewed interventional radiology journal. As the official journal of the Society of Interventional Radiology, JVIR is the peer-reviewed journal of choice for interventional radiologists, radiologists, cardiologists, vascular surgeons, neurosurgeons, and other clinicians who seek current and reliable information on every aspect of vascular and interventional radiology. Each issue of JVIR covers critical and cutting-edge medical minimally invasive, clinical, basic research, radiological, pathological, and socioeconomic issues of importance to the field.