Development and Characterization of a Large Animal Model for Iliofemoral Deep Vein Thrombosis Secondary to Chronic Iliac Vein Stenosis.

IF 1.6 4区 医学 Q3 PERIPHERAL VASCULAR DISEASE
Xicheng Zhang, Guanqiang Li, Bo Hu, Xianchen Huang, Yuan Sun
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Abstract

Objective: To establish a large animal model of deep venous thrombosis (DVT) secondary to chronic iliac vein stenosis (IVS) that can simulate pathophysiologic processes in humans.

Methods: Iliac vein stenosis models with degrees of stenosis of approximately 30%, 50%, 70%, and 90% were developed in 4 groups of 12 adult goats using a novel controllable ligation technique. Four weeks later, the stenotic lesion was evaluated by digital subtraction angiography (DSA) and optical coherence tomography (OCT), after which iliac vein thrombosis adjacent to the stenosis was induced by balloon blockade combined with thrombin injection. Three days after thrombosis, the process of clinical thrombus clearance was simulated by a rheolytic thrombectomy catheter, and the IVS was corrected by balloon angioplasty and stent implantation.

Results: After controllable ligation, venography revealed iliac vein stenosis degrees of 31.39±3.09%, 48.95±1.24%, 71.34±5.12%, and 89.78±4.66% in the four groups. After 4 weeks, DSA and OCT showed obvious collateral circulation and intimal hyperplasia around stenotic lesions in Group 3, which was consistent with the secondary pathological changes in IVS in humans. The iliac veins in Groups 1 and 2 remained patent without obvious collateral circulation, while Group 4 showed complete iliac vein occlusion with extensive collaterals. Thrombosis was successfully induced in Groups 1 and 2, but Groups 3 and 4 required repeated thrombin injections and a shortened distance between the two balloons. Clinical thrombus-clearing devices removed most thrombi, and residual stenosis was corrected by balloon angioplasty and stent implantation. OCT confirmed optimal stent apposition.

Conclusion: This study developed a caprine model of IVS-related thrombosis, which can facilitate research on the IVS-DVT relationship and the evaluation of thrombectomy devices and specialized stents for IVS.

慢性髂静脉狭窄继发髂股深静脉血栓形成大型动物模型的建立与表征。
目的:建立能模拟人体慢性髂静脉狭窄(IVS)继发深静脉血栓形成(DVT)病理生理过程的大型动物模型。方法:采用新型可控结扎技术,建立4组12只成年山羊髂静脉狭窄模型,狭窄程度分别为30%、50%、70%和90%。4周后,行数字减影血管造影(DSA)和光学相干断层扫描(OCT)评估狭窄病变,球囊阻断联合注射凝血酶诱导狭窄附近髂静脉血栓形成。血栓形成后3天,通过溶栓导管模拟临床血栓清除过程,并通过球囊血管成形术和支架植入术纠正静脉血栓。结果:可控结扎后静脉造影显示四组髂静脉狭窄程度分别为31.39±3.09%、48.95±1.24%、71.34±5.12%、89.78±4.66%。4周后,DSA和OCT显示3组狭窄灶周围有明显的侧支循环和内膜增生,这与人类IVS的继发病理变化一致。1、2组髂静脉通畅,无明显侧支循环,4组髂静脉完全闭塞,侧支广泛。第1组和第2组血栓形成成功,但第3组和第4组需要多次注射凝血酶,并缩短两个气球之间的距离。临床血栓清除装置清除了大部分血栓,剩余的狭窄通过球囊血管成形术和支架植入得到纠正。OCT确认最佳支架放置位置。结论:本研究建立了IVS相关血栓形成的山羊模型,有助于研究IVS- dvt的关系,以及对IVS取栓装置和专用支架的评价。
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来源期刊
CiteScore
3.00
自引率
13.30%
发文量
603
审稿时长
50 days
期刊介绍: Annals of Vascular Surgery, published eight times a year, invites original manuscripts reporting clinical and experimental work in vascular surgery for peer review. Articles may be submitted for the following sections of the journal: Clinical Research (reports of clinical series, new drug or medical device trials) Basic Science Research (new investigations, experimental work) Case Reports (reports on a limited series of patients) General Reviews (scholarly review of the existing literature on a relevant topic) Developments in Endovascular and Endoscopic Surgery Selected Techniques (technical maneuvers) Historical Notes (interesting vignettes from the early days of vascular surgery) Editorials/Correspondence
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