Experimental study on acute ischemic small bowel changes induced by superselective embolization of superior mesenteric artery branches with N-butyl cyanoacrylate
Experimental study on acute ischemic small bowel changes induced by superselective embolization of superior mesenteric artery branches with N-butyl cyanoacrylate
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DOI：
10.1016/j.jvir.2008.01.024
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发表时间：
2008-05-01
影响因子：
2.9
通讯作者：
Park, Jae Hyung
中科院分区：
文献类型：
--
作者：
Jae, Hwan Jun;Chung, Jin Wook;Park, Jae Hyung
目得：评价用氰基丙烯酸正丁酯（NBCA）在直血管水平超选择性栓塞犬肠系膜上级动脉（SMA）分支后小肠缺血性变化的程度。3材料与方法：在6只狗的直血管水平，用NBCA超选择性栓塞SMA的5个孤立分支。栓塞后24小时处死所有犬。根据标本X线片上NBCA混合物的程度，将栓塞段分为A组（栓塞3个或更少的直血管）和B组（栓塞4个或更多的直血管）。组织学评价的粘膜，粘膜下层，和肌肉层的栓塞段进行了由病理学家。结果：在A组（n = 15），组织学检查结果是正常的7段（47%）。在八个节段的粘膜层、四个节段的粘膜下层和一个节段的肌肉层中观察到轻度缺血性变化。B组（n = 15）15个节段的粘膜层、14个节段的粘膜下层和10个节段的肌层均出现缺血性改变。A组和B组之间缺血性损伤的差异有统计学意义。结论：涉及三个或更少的SMA直血管的超选择性栓塞是相对耐受的，涉及四个或更多的直血管的栓塞进行了大量缺血性肠损伤的风险增加。进一步的研究是必要的，以确定我们的研究结果在人类受试者的临床意义。
PURPOSE: To evaluate the degree of ischemic changes of the small bowel after superselective embolization of superior mesenteric artery (SMA) branches at the vasa recta level with N-butyl cyanoacrylate (NBCA) in dogs. 3MATERIALS AND METHODS: In six dogs, superselective embolization was performed with NBCA in five isolated branches of the SMA at the vasa recta level. All dogs were sacrificed 24 hours after embolization. According to the extent of the NBCA mixtures on radiographs of the specimen, embolized segments were divided into group A (embolization of three or fewer vasa recta) or group B (embolization of four or more vasa recta). Histologic evaluation of the mucosal, submucosal, and muscle layers of the embolized segments was performed by a pathologist.RESULTS: In group A (n = 15), histologic findings were normal in seven segments (47%). Mild ischemic changes were noted in the mucosal layer in eight segments, the submucosal layer in four segments, and the muscle layer in one segment. In group B (n = 15), ischemic changes were noted in the mucosal layer in all 15 segments, the submucosal layer in 14 segments, and the muscle layer in 10 segments. The difference in ischemic damage between groups A and B was statistically significant.CONCLUSIONS: Superselective embolization involving three or fewer vasa recta of the SMA was relatively tolerable, and embolization involving four or more vasa recta carried an increased risk of substantial ischemic bowel damage. Further studies are necessary to determine the clinical implications of our findings in human subjects.