| 摘要: |
| 目的：探索一种较为理想的、稳定可靠的Stanford B型主动脉夹层动脉瘤（TAD）模型的建立方法。方法：12条犬左侧开胸后侧壁阻断降主动脉近端，环形切开外膜、中膜约1/2周径（保持内膜的完整性）；找到动脉壁分层裂隙，沿裂隙用特制剥离子向下、侧方、向上分离。再环形剪开内膜约1/2周径，将已切开的内膜下唇双角处分别缝合固定于邻近的侧动脉壁，然后将远端外膜及中膜缝合于近端主动脉壁上。再经一侧髂总动脉穿刺，用碘海醇造影剂以16～18 ml/s速度经猪尾巴导管DSA造影及彩超跟踪检查。结果：直视下观察全部动脉夹层立即形成并向远端撕裂。术中彩超影像跟踪、即时DSA造影和术后不同时间点获取动脉标本检查均显示夹层动脉瘤形成。结论：应用主动脉内膜片双角缝合法，可建立与人体Stanford B型TAD病理过程相似的Stanford B型TAD动物模型。 |
| 关键词: 内膜片双角缝合法 Stanford B型主动脉夹层动脉瘤 模型，动物 |
| DOI：10.3724/SP.J.1008.2007.00995 |
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| 基金项目:上海市血管系统疾病临床医学中心基金(ZX03B1). |
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| Two-end intimal flap suturing method in establishing Stanford B type aortic dissection model in canine |
| CUI Jia-sen，MEI Zhi-jun， JING Zai-ping*，ZHANG Jian,WANG Li-xin |
| (Department of Vascular Surgery，Changhai Hospital，Second Military Medical University，Institute of Vascular Surgery of PLA，Shanghai 200433，China) |
| Abstract: |
| Objective：To search for a satisfactory method for establishing Stanford B type aortic dissection model in canine.Methods: Totally 12 adult dogs were used in the present study.The proximal descending aorta was clamped partially and laterally after a left thoracotomy; half circumference of the aorta,including the media and adventitia,was cut open transversely,with the intima kept intact.The aortic wall was then separated inferiorly,laterally and superiorly at a special dissecting space with a unique dissecting device.Then the intima at the same site was also cut open transversely and the two ends of the distal intimal flap were sutured to the adjacent aorta to allow blood entry.The distal adventitia and media were sutured to the proximal aorta to close the incision.Follow-up was carried out with pigtail catheter guided digital subtraction angiography (DSA) using omnipaque (16-18 ml/s) via either of the common iliac arteries and color Doppler ultrasound.Results: Formation and distal extension of aortic dissections were observed immediately after the procedure and were further confirmed by intra-operative color Doppler ultrasound,DSA,and post-operative biopsy at different time points.Conclusion: The present two-end intimal flap suturing method can be used for establishing Stanford B type aortic dissection model in canine; the model is similar to human Stanford B type aortic dissection. |
| Key words: tow-end intimal flap suturing method Stanford B type aortic dissection models,animal |
