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经导管应用新型无膜双腰封堵器封堵犬单侧肾动脉
陆阳1,夏阳2,陈翔1,张建1,张志刚1,赵仙先1*
0
(1. 第二军大学长海医院心血管内科, 上海 200433;
2. 第二军大学长海医院呼吸与危重症医学科, 上海 200433
*通信作者)
摘要:
目的 在大动物中观察新型无膜双腰封堵器应用的安全性及有效性。方法 选取健康实验犬12只,应用新型无膜双腰封堵器进行单侧肾动脉封堵,封堵后即刻行肾动脉造影评估封堵效果,并于术后1、3及6个月复查肾动脉造影。复查造影结束后处死实验犬,观察肾脏大体标本并行肾脏病理检查,并观察封堵器表面内皮化情况。结果 12只实验犬均成功实施单侧肾动脉封堵,其中1只因麻醉药物过量死亡,其余11只存活良好。6只实验犬在植入封堵器后即刻完全封堵,全部实验犬均在植入封堵器后12 min内完全封堵肾动脉血流。封堵器释放后,封堵器位置均固定良好,未见明显封堵器移位。所有实验犬复查肾动脉造影均显示封堵器位置固定良好,无残余分流。大体观察发现封堵侧肾脏较对侧肾脏明显缩小,肾脏表面凹凸不平,质略硬。内皮细胞在术后1个月即开始覆盖封堵器表面,3个月时内皮细胞完全覆盖。结论 新型无膜双腰封堵器具有良好的安全性、组织相容性及有效性,由于其优异的通过性,在小外径鞘管内即可完成封堵器输送。
关键词:  经导管  双腰封堵器  肾动脉  安全性  组织相容性
DOI:10.16781/j.0258-879x.2016.06.0767
投稿时间:2015-10-12修订日期:2015-12-13
基金项目:
Transcatheter closure of unilateral renal artery with a newly-developed double waist occluder in dogs
LU Yang1,XIA Yang2,CHEN Xiang1,ZHANG Jian1,ZHANG Zhi-gang1,ZHAO Xian-xian1*
(1. Department of Cardiovasology, Changhai Hospital, Second Military Medical University, Shanghai 200433, China;
2. Department of Respiratory and Critical Medicine, Changhai Hospital, Second Military Medical University, Shanghai 200433, China
*Corresponding author)
Abstract:
Objective To evaluate the safety and efficacy of transcatheter closure of renal artery with a newly-developed double waist occluder in dogs. Methods A newly-developed double waist occluder was implanted in the right renal arteries of 12 healthy dogs. The location of devices was observed by angiography immediately, and 1, 3 and 6 months after occlusion. Renal specimens and occluders was observed after the animals were sacrificed and pathological examination was conducted. Also the endothelialization on the surface of the occluders was observed. Results Transcatheter closure of unilateral renal artery was successfully performed in all the 12 dogs. One dog died due to overdose of narcotic drugs, and the other 11 dogs survived well. Complete occlusion of the renal artery was achieved in 6 dogs immediately after the occluder was implanted, and complete occlusion was seen in all the dogs within 12 min after occlusion, with all the devices in good position and without translocation. Repeated angiography showed in all animals that the occluders were in good position and without residual shunt. The occluded kidneys became smaller than the opposite ones, with the surface of occluded kidney turning lumpy and hard. Endocardial cells started to cover the surface of occluder 1 month after closure and complete coverage was seen 3 months later. Conclusion The newly-developed double waist occluder is safe, feasible and effective, and it can be delivered in small sheath owning to its excellent trafficability.
Key words:  transcatheter  double waist occluder  renal artery  safety  histocompatibility