颅内动静脉畸形动物模型制作与栓塞的实验研究

摘要

Objective　To explore the creation of intracranial arteriovenous malformation (AVM) animal model and its application in embolization.rnMethods　Using their rete mirabile (ReM) as nidus of AVM, we selected nine Chinese Experimental Mini-pigs (CEMPs) to create AVM animal models mainly by right carotid-jugular anastomosis (CJA) and ligation of the right external carotid artery. The models were embolized respectively with n-butal 2-cyanoacrylate and embosphere, and the ReM, CJA vessel and brain of the animal were removed for histopathological observation. Angiographies were arranged before and after model creation as well as pre- and post embolization. Combined with angio-images and histopathological findings, the applications of the model, the reason of CJA stoma occlusion, and the possibility of model improvement were discussed. rnResults　The AVM animal model was successfully created in seven 　CEMPs, which was similar to 　human brain 　AVM in angio-architecture, angiographic-image, embolizing behavior and post embolization pathological findings. Thromboses were found inside the CJA vessels in 4 animals and in the rest 3 the CJA vessels were shrunk without thrombus. The brain histopathological changes of the dead animal after embolization were of ischemic infarction.rnConclusions　Although our method is relatively more simple and rather reliable, which is suitable for the embolizing research of embolic agents and for the training of interventional staff, it reaches however an acute (short-term) model and its applications are evidently limit. How to prevent the CJA stoma occlusion and to let animal tolerate the embolization need further studies.%目的探讨颅内动静脉畸形(arteriovenous malformation, AVM)动物模型的制作与其在栓塞研究中的应用。方法以中国实验小型猪(Chinese Experimental Mini-pigs，CEMPs)颅底微血管网（rete mirabile，ReM）为AVM的畸形团，经右颈动静脉吻合并结扎右颈外动脉等建立AVM动物模型，用α-氢基丙烯酸正丁酯(NBCA)胶和Embosphere颗粒分别栓塞，模型建立和栓塞前后行血管造影，并取栓塞组织（ReM）、颈动静脉吻合口和脑做组织病理学检查。结合造影影像和组织病理学发现，探索模型的应用、颈动静脉吻合口的闭塞原因和模型改进方法。结果在7只CEMPs中成功制作了AVM动物模型，该模型在血管结构、造影影像、栓塞表现和栓塞后病理改变上与人脑AVM的相似。4只动物颈动静脉吻合口血管腔内有血栓形成，其余3只吻合口血管塌陷皱缩，腔内无血栓。死亡动物脑组织病理表现为缺血性梗塞。结论尽管本方法对于建立颅内AVM动物模型更简单可行，适用于栓塞材料的栓塞研究和介入医师的培训，但该模型仍为急性期模型，其应用十分有限。如何防止模型动静脉吻合口的闭塞和让动物能够耐受栓塞，需要进一步的研究。