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中华介入放射学电子杂志 ›› 2018, Vol. 06 ›› Issue (04) : 332 -338. doi: 10.3877/cma.j.issn.2095-5782.2018.04.012

所属专题: 文献

基础研究

异物创伤性动脉瘤犬模型构建的初步探讨
文颖1, 杨秀军1,(), 李婷婷1, 乐萱1   
  1. 1. 200062 上海交通大学附属儿童医院影像科
  • 收稿日期:2018-08-23 出版日期:2018-11-01
  • 通信作者: 杨秀军
  • 基金资助:
    上海市科委动物实验项目(16140901500)

Initial study on modeling of traumatic aneurysm with foreign body in canine

Ying Wen1, Xiujun Yang1,(), Tingting Li1, Xuan Le1   

  1. 1. Department of Radiology, Shanghai Children's Hospital, Shanghai Jiao Tong University, Shanghai 200062, China
  • Received:2018-08-23 Published:2018-11-01
  • Corresponding author: Xiujun Yang
  • About author:
    Corresponding author: Yang Xiujun, Email:
引用本文:

文颖, 杨秀军, 李婷婷, 乐萱. 异物创伤性动脉瘤犬模型构建的初步探讨[J]. 中华介入放射学电子杂志, 2018, 06(04): 332-338.

Ying Wen, Xiujun Yang, Tingting Li, Xuan Le. Initial study on modeling of traumatic aneurysm with foreign body in canine[J]. Chinese Journal of Interventional Radiology(Electronic Edition), 2018, 06(04): 332-338.

目的:

建立异物创伤性动脉瘤的犬模型,为伴血管损伤软组织异物一站式介入治疗研究提供动物模型。

方法:

随机选取2年龄的健康雄性比格犬7只,分为颈动脉瘤造模5只和未造模2只,造模于右侧颈动脉共5支血管为研究组,其左侧颈动脉及未造模2只犬两侧颈动脉共9支血管为对照组。研究组将长约15~20 mm的离断颈静脉剪开、缝合于同侧颈总动脉前璧上,以弯型断针穿破静脉片及动脉前壁,静脉片-动脉壁间腔搏动性充盈且无缝缘渗漏后,断针部分留存于该间腔甚或动脉腔内,逐层缝合手术区域组织。然后,经皮经股动脉插管选择性颈总动脉进行数字减影血管造影(DSA)。对照组颈动脉仅于其旁以缝针经皮扎伤软组织且无明显出血及血肿。术前、术后行颈部CT血管成像(CTA)和数字放射摄影(DR)检查与评估。

结果:

研究组5支右侧颈动脉断针创伤性动脉瘤均成功造模,技术成功率100%;DSA清晰显示动脉破口、动脉瘤状动脉突起及断针异物,载瘤动脉局部轻度痉挛及狭窄,创伤性动脉瘤模型的瘤颈宽度为(2.1±1.3)mm,瘤体宽(9.7±1.1)mm,瘤体高(4.2±1.7)mm;CTA不如DSA显示效果佳。对照组9支颈动脉均正常。

结论:

采用颈静脉片侧-侧吻合于同侧颈动脉前壁上并以断针穿破静、动脉壁且断针部分留置于其间的技术与方法,成功构建了异物创伤性动脉瘤犬模型。

Objective:

To establish the model of traumatic aneurysm with foreign body in canine carotid artery, and to provide an animal model for one-stop interventional treatment of soft-tissue foreign body with vascular injury.

Methods:

Seven healthy male Beagles dogs aged about 2 years were randomly modeled on right carotid artery in 5 and unmodeled in 2. In the research group with 5 carotid arteries, local jugular vein about 15-20 mm in length was cut off and sewn into the anterior wall of the ipsilateral carotid artery with 6-0 suture. The curved suture needle was then worn through the vein and artery, and kept partially in them even in the artery cavity. The tissues in surgical area were sutured layer by layer after the artificial cavity between the vein and arterial walls pulsating protrusion without leakage from the stitched edge. Finally, selective common carotid artery digital subtraction angiography (DSA) was performed by percutaneous transfemoral artery to further confirm the aneurysm model. In control group with 9 carotid arteries, only soft tissues surrounding the common carotid artery were percutaneously injured using a needle without significant bleeding and hematoma. Digital radiographs and CT angiography of neck were performed before and after the modeling operation.

Results:

Five traumatic aneurysms with foreign body of broken needle were made successfully in canine common carotid artery, and the technical success rate of establishment of traumatic aneurysm with foreign body was 100%. DSA clearly showed the arterial rupture, aneurysm, broken needle, and mild vasospasm and stenosis of local parent artery, which showed poorly on CTA. No abnormal findings were shown in common carotid arteries in control group.

Conclusions:

The canine model of foreign body within traumatic aneurysm was successfully constructed using the method of a residual broken needle breaking through the anastomotic vessel wall after a side-to-side anastomosis to the carotid artery wall with a piece of ipsilateral jugular vein.

图1 将长约15 mm离断并纵行切开的颈静脉片完整地缝合于同侧颈总动脉前壁上
图2 用尖段咬断的弯型缝针同时穿破静脉片和动脉前壁(断针前端需多次"捣鼓"以扩大动脉前壁破口),静脉片因血流充盈而膨隆、涨大,并可见与颈动脉一致的搏动——动脉瘤造模成功重要标志,断针前段留在瘤腔及动脉腔内
图3 右侧颈总动脉DSA,动脉瘤(右箭头)呈囊状突起影像改变,断针(下箭头)部分留置于瘤体及动脉腔内,载瘤动脉可见局部血管轻度痉挛与狭窄
图4 术后1 h内CT血管成像显示颈动脉局限性突起凸向血管腔外及针状异物(箭头),局部轻度血管狭窄
图5 术后2周复查CT血管成像仅示针状异物,未见明显动脉瘤影像,血管狭窄明显改善
图6 术前平片显示颈部未见异物影
图7 术后平片显示颈部气管右旁软组织内针状异物影(箭头)
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