经股动脉入路建立球囊损伤兔颈动脉狭窄模型

目的经股动脉入路制作一种实用、可靠且稳定的颈动脉狭窄模型,用于探讨颈动脉再狭窄的防治。方法新西兰大白兔20只,随机分为对照组、实验1周组、实验2周组和实验4周组,每组5只,常规喂养。所有动物采用经右侧股动脉入路置入HyperForm球囊,实验组行右颈总动脉定比扩张,对照组行单纯右颈动脉路图显示,术后以普通饮食喂养。实验1、2、4周组实验兔分别于手术后1周、2周和4周处死,并在第4周同时处死对照组兔。右颈动脉分叉近心端1～2cm节段取材送光镜和电镜检查,分别观察血管壁增生情况并计算血管内膜和中膜厚度。结果与对照组比,实验组新生内膜厚度呈持续性显著增加(P<0.01),实验2周组与实验1周组比较及实验4周组与实验2周组相比,内膜厚度均显著增加(P<0.01)。各组中膜厚度未见明显统计学差异(P>0.05)。结论经股动脉入路用Hyper Form球囊行颈动脉定比扩张能成功地制作一种稳定、简便可靠的颈动脉狭窄动物实验模型。血管平滑肌细胞的过度增生是造成PTA术后管腔再狭窄的主要因素。

Establishment of rabbit carotid artery stenosis model after balloon injury via femoral artery approach

Objective To establish a practical and stable carotid artery stenosis model via femoral artery approach and discuss the prevention and treatment of carotid artery restenosis.Methods Twenty New Zealand rabbits were randomly divided into 4 equal groups(control group, groups 1-week, 2-week and 4-week), 5 each, and fed under conventional feeding condition.The HyperForm balloon catheter was introduced into the right common carotid artery(CCA) through a small window in the right femoral artery.Road map of the right CCA was drawn in the control group.In the test groups, inflated balloon was placed to mechanically expand the right CCA.The rabbits were given normal diet feeding after operation.At 1st, 2nd and 4th week after the balloon injury, the rabbits of groups 1-week, 2-week and 4-week were killed respectively.The rabbits in the control group were also killed at the 4th week.1-2 cm segment proximal to the right CCA bifurcation were taken for light and electron microscopy to observe vascular proliferation and calculate the thickness of vascular intima and media.Results Compared with the control group, the mean thickness of neointima in test groups were significantly increasing(P<0.01).Compared with the group 1-week and group 4-week, the thickness of intima in group 2-week significantly thickened(P<0.01).There was no statistical difference in tunica media thickness between the groups(P>0.05).Conclusion A practical carotid artery stenosis model is successfully established by proportionally expanding the CCA with HyperForm balloon, which also can stimulate the pathological process of the injured endothelium after angioplasty.Hyperproliferation of vascular smooth muscle cells is a main factor of artery restenosis after percutaneous transluminal angioplasty.