摘要
目的 观察髂静脉支架植入后覆盖对侧髂静脉开口,局部区域的形态和病理学变化,探讨对另一侧髂静脉血流的影响.方法 12条犬左髂静脉植入裸支架,支架上缘进入下腔静脉（IVC）并覆盖对侧髂静脉开口.术后4、8、12周彩色多普勒超声检查血流,取出血管支架及静脉行病理学检查,观察支架表面的新生内膜.结果 12条犬术后无支架闭塞或髂静脉血栓形成.覆盖对侧髂静脉开口的裸支架边缘有明显的新生内膜,并向支架中央爬行,以对侧髂静脉开口的下缘最明显.术后4、8和12周的右髂静脉开口部裸支架的新生内膜面积分别为（9.33±1.54）％、（10.65±1.01）％和（10.92±1.30）％,组间比较差异无统计学意义（P＞0.05）;扫描电镜示中央支架网丝表面有内膜覆盖,术后4、8周中间支架网丝表面内膜覆盖率分别为（63.58±12.39）％、（97.13±2.71）％,两者差异有统计学意义（P＜0.01）,12周内膜覆盖率为（99.63±0.60）％,与8周组比较差异无统计学意义（P＞0.05）.结论 髂静脉支架植入后覆盖对侧髂静脉开口,彩色超声检查对另侧髂静脉血液回流无明显影响,对侧裸支架边缘有一定程度的内膜增生,中央的支架网丝表面也有胶原纤维沉积、内皮细胞覆盖,并随时间延长明显.但并未观察到在支架网丝间形成桥接.
Objective To investigate the morphology and pathological changes after iliac venous stent implantation upon the contralateral iliac vein when the stents were placed into the inferior vena cava.Methods 12 healthy adult Beagle canines were subject to self-expandable bare stent implantation into the left common iliac vein.Proximal end of the vascular stent completely covered the opening of the right iliac vein.Color doppler examination was conducted to monitor the blood flow at postoperative 4,8 and 12 weeks.Animals were sacrificed at postoperative 4,8 and 12-week.Iliac vein and inferior vena cava including vascular stents were collected.Scanning electron microscopy were performed to observe and analyze the growth of inner membrane onto the vascular stents,and statistically compare the covering of the new inner membrane on the stent surface located at the opening of contralateral iliac vein.Results Stents were successfully implanted into 12 animals.Postoperative color Doppler examination revealed that no iliac venous stent-induced thrombosis or contralateral iliac venous thrombosis formed.New inner membrane formed adjacent to the edge of bare stent located at the opening of right iliac vein and grew towards the stent center,especially the intimal hyperplasia surrounding the inferior edge of the stent which partially covered the opening of the right iliac vein.At postoperative 4,8 and 12 weeks,the area of new neointima on the bare stent located at the opening of the right iliac vein were （9.33 ± 1.54） %,（10.65 ± 1.01） % and （10.92 ± 1.30）% with no statistical significance among three groups （P 〉 0.05）.Electron microscopy revealed that new neointima was notably seen the central stent at the opening of right iliac vein.The covering rates of neointima on the stent struts were（63.58 ± 12.39）%,（97.13 ±2.71）% and （99.63 ±0.60）% at postoperative 4,8 and 12 weeks,there is a statistical significance between 4 and 8 weeks groups（P 〈 0.01）.Scaning electon analysis showed the saface of endomembrane were composed of endothelial cells,but there is no statistical significance between 8 and 12 weeks groups.Conclusion Experimental outcomes indicated that a certain degree of intimal hyperplasia occurred in the stent at the opening of right iliac vein and partially covered the opening of bare stent.Obvious coverage of hyperplastic neointima were seen on the stent mesh in the middle of the the opening of contralateral iliac vein.But these experimental outcomes indicated that there are no significant effects upon the blood backflow by Color Doppler examination.
出处
《中华实验外科杂志》
CAS
CSCD
北大核心
2016年第5期1190-1193,共4页
Chinese Journal of Experimental Surgery
基金
扬州市社会发展科技攻关资助项目（2012146）
关键词
髂静脉
裸支架
病理学
血管内膜增生
Iliac vein
Bare stent
Pathology
Vascular intimal hyperplasia
