Document Detail


Endovascular creation of aortic dissection in a swine model with technical considerations.
MedLine Citation:
PMID:  22226563     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Creating an experimental model of a type B aortic dissection with a minimally invasive endovascular procedure in swine to help future evaluation of therapies for aortic dissection.
METHODS: Aortic dissection was created in 14 swine using endovascular procedures only. Under fluoroscopy, a modified 10F outer catheter with a 14 G stiffening inner metallic cannula was forced via the femoral artery into the aortic vessel wall to create an initial dissection. A .035-inch guidewire and a 4F straight catheter were advanced into the dissected space, and the dissection was extended in a retrograde direction using a technique including loop formation of the guidewire, which was placed carefully against the transmural penetration and extended as far as possible in the descending thoracic aorta up to the point where loop formation of the guidewire reached smoothly. An 8F introducer sheath was advanced with a Brockenbrough needle into the dissected space, and a proximal fenestration was created by puncturing the intima. If required, balloon dilatation was performed to enlarge the proximal and distal tears. Aortography and contrast-enhanced cone beam computed tomography (CBCT) were performed in addition to a detailed histologic evaluation of the dissected portion.
RESULTS: Aortic dissection was successfully created in 11 of the 14 swine (78.6%). Among the 11 dissections, nine were located in the thoracoabdominal aorta and two in the abdominal aorta. The initial aortic diameter at the middle portion of the created dissection ranged from 7.4 to 16.8 mm (mean ± standard deviation, 10.9 ± 2.9), while after dissection, it ranged from 7.8 to 19.3 mm (12.9 ± 3.8 mm). The dissected length ranged from 4.4 to 17.7 cm (10.7 ± 4.6 cm). Aortography and CBCT revealed seven dissections (63.6%) with a smooth and patent false lumen. Histologic evaluation revealed that the outer one-third of the media was separated from the inner two-thirds. In the remaining four dissections (36.4%), imaging procedures revealed the formation of a rough and patent false lumen beside the true lumen, and histologic evaluation revealed greater separation of the outer media. Five animals were chronic dissection models. Three (60%) of these survived for more than 14 days without any symptoms. Moreover, completely patent true and false lumens without thrombus formation were observed in these three animals. The aortic diameter at the dissected portion tended to be dilated compared with the initial diameter.
CONCLUSIONS: This new technique of creating an experimental aortic dissection model in swine is promising and should contribute to the development of future therapies for aortic dissection.
Authors:
Teruaki Okuno; Masato Yamaguchi; Takuya Okada; Takuya Takahashi; Noriaki Sakamoto; Eisuke Ueshima; Kazuro Sugimura; Koji Sugimoto
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Publication Detail:
Type:  Journal Article     Date:  2012-01-05
Journal Detail:
Title:  Journal of vascular surgery     Volume:  55     ISSN:  1097-6809     ISO Abbreviation:  J. Vasc. Surg.     Publication Date:  2012 May 
Date Detail:
Created Date:  2012-04-30     Completed Date:  2012-06-20     Revised Date:  2012-10-03    
Medline Journal Info:
Nlm Unique ID:  8407742     Medline TA:  J Vasc Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1410-8     Citation Subset:  IM    
Copyright Information:
Copyright © 2012 Society for Vascular Surgery. Published by Mosby, Inc. All rights reserved.
Affiliation:
Department of Radiology and Center for Endovascular Therapy, Kobe University Graduate School of Medicine, Kobe, Japan. ter555@hotmail.co.jp
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MeSH Terms
Descriptor/Qualifier:
Aneurysm, Dissecting / etiology*,  pathology,  radiography
Animals
Aortic Aneurysm, Abdominal / etiology*,  pathology,  radiography
Aortic Aneurysm, Thoracic / etiology*,  pathology,  radiography
Aortography
Balloon Dilation / adverse effects
Cone-Beam Computed Tomography
Contrast Media / diagnostic use
Disease Models, Animal
Endovascular Procedures / adverse effects*
Female
Radiography, Interventional
Swine
Time Factors
Chemical
Reg. No./Substance:
0/Contrast Media

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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