Document Detail


Experimental model of large pulmonary embolism employing controlled release of subacute caval thrombus in swine.
MedLine Citation:
PMID:  21802315     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To develop a catheter-based model of large pulmonary embolism (PE) in swine based on in situ venous thrombus formation.
MATERIALS AND METHODS: Ten Yorkshire swine underwent transjugular implantation of a retrievable inferior vena cava (IVC) filter. A thrombin and collagen mixture was injected into a confined space created by two balloons inflated proximal and distal to the IVC filter. Animals were left to survive for 7 days ± 3 to allow thrombus to organize in situ. The caval thrombus was released on transcatheter retrieval of the IVC filter and embolized into the main and branch pulmonary arteries. The severity of PE was scored based on digital subtraction angiography with the Miller index. At necropsy, thrombi were recovered and analyzed histopathologically.
RESULTS: Large PE was induced in all animals (Miller index score of 15 ± 5). Two animals developed saddle embolus with bilateral pulmonary artery occlusion, and five developed proximal occlusion of the left or right pulmonary artery. Nevertheless, no animal exhibited significant hemodynamic compromise. Large tubular thrombi were explanted in the size range of 5-10 cm long and 0.5-1 cm wide. Histologic analysis indicated an organized thrombus with infiltration of white blood cells and fibrin deposition.
CONCLUSIONS: Large caval thrombi can be formed in vivo and released at a predetermined time to induce large PE in a large animal model. This may help in the development and testing of new therapeutic approaches for PE.
Authors:
Israel M Barbash; William H Schenke; Majdi Halabi; Kanishka Ratnayaka; Anthony Z Faranesh; Ozgur Kocaturk; Robert J Lederman
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, N.I.H., Intramural     Date:  2011-07-28
Journal Detail:
Title:  Journal of vascular and interventional radiology : JVIR     Volume:  22     ISSN:  1535-7732     ISO Abbreviation:  J Vasc Interv Radiol     Publication Date:  2011 Oct 
Date Detail:
Created Date:  2011-10-03     Completed Date:  2012-02-03     Revised Date:  2013-06-28    
Medline Journal Info:
Nlm Unique ID:  9203369     Medline TA:  J Vasc Interv Radiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1471-7     Citation Subset:  IM    
Copyright Information:
Copyright © 2011 SIR. Published by Elsevier Inc. All rights reserved.
Affiliation:
Cardiovascular and Pulmonary Branch, Division of Intramural Research, National Heart Lung and Blood Institute, National Institutes of Health, Bethesda, MD 20892-1538, USA.
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MeSH Terms
Descriptor/Qualifier:
Angiography, Digital Subtraction
Animals
Balloon Occlusion
Collagen
Device Removal
Disease Models, Animal
Hemodynamics
Pulmonary Artery* / pathology,  physiopathology,  radiography
Pulmonary Embolism / etiology*,  pathology,  physiopathology,  radiography
Radiography, Interventional
Swine
Thrombin
Time Factors
Vena Cava Filters
Vena Cava, Inferior* / pathology,  radiography
Venous Thrombosis / chemically induced,  complications*,  pathology,  radiography
Grant Support
ID/Acronym/Agency:
1ZIAHL005062-08//PHS HHS; Z01-HL006041-01/HL/NHLBI NIH HHS; ZIA HL005062-08/HL/NHLBI NIH HHS; ZIA HL006041-01/HL/NHLBI NIH HHS
Chemical
Reg. No./Substance:
9007-34-5/Collagen; EC 3.4.21.5/Thrombin
Comments/Corrections

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


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