Thromboembolization associated with sudden increases in flow in a coronary stent ex vivo shunt model.
Thromboembolization associated with sudden increases in flow in a coronary stent ex vivo shunt model.
复制标题
冠状动脉支架离体分流模型中与血流突然增加相关的血栓栓塞。
DOI：
10.1097/00002480-200005000-00012
复制
发表时间：
2000
期刊：
影响因子：
4.2
通讯作者：
K. Solen
中科院分区：
文献类型：
--
作者：
S. Sukavaneshvar;Y. Zheng;G. M. Rosa;S. Mohammad;K. Solen
为了观察血栓栓塞症(TE)动物模型的动态变化，建立了一种颈动脉-颈动脉体外分流术。在分流术中，冠状动脉支架被放置在3.5 mm聚氯乙烯(PVC)管段中作为模型装置。光散射微栓子检测器监测流经分流管的血液的栓子含量，通过夹持式超声血流探头测定，速度为50-150毫升/分钟。当激活凝血时间(ACT)保持在125-150秒之间时，支架能活跃地形成血栓并释放栓子1-3小时。根据动物的活动，分流流量波动很大(从50到150毫升/分钟)。当这种波动流速的时间剖面叠加在栓塞的时间剖面上时，注意到流速的突然增加与栓塞事件相关。统计数据显示，流量突然增加100%或以上，95%的时间伴随有血栓事件(p<；0.01)。根据这项研究的结果，推测栓塞率的增加可能是由于与加速血流相关的流体力所致。为了探索这一假设，我们进行了体外研究，比较了脉动流和恒定流对支架诱导的TE的影响。这项研究的结果表明，与稳定流动相比，脉动流动中支架血栓形成和血栓形成的发生率均显著增加(100%)。
To observe the dynamics of thromboembolism (TE) in an animal model, a carotid-carotid arterial ex vivo shunt was developed. A coronary stent deployed in a 3.5 mm polyvinylchloride (PVC) tubing segment was used as a model device in the shunt. A light-scattering microemboli detector monitored the embolic content of the blood flowing through the shunt at 50-150 ml/min as determined by a clamp-on ultrasound flow probe. The stent was found to actively develop thrombi and release emboli for 1-3 hours when the activated clotting time (ACT) was maintained between 125 and 150 seconds. The shunt flow rate fluctuated considerably (from 50 to 150 ml/min) depending on the animal's activity. When the time profile of this fluctuating flow rate was super imposed on the time profile of embolization, it was noted that sudden increases in flow rate were associated with incidents of embolization. Statistically, sudden flow rate increases of 100% or more were accompanied by embolic events 95% of the time (p < 0.01). Based on the results of this study, it was postulated that the increased embolization may be due to the fluid forces associated with accelerating flow. To explore this postulate, in vitro studies were conducted to compare the effects of pulsatile flow with steady flow on stent induced TE. Results of this study suggested a significant increase (100%) in both stent thrombosis and embolism during pulsatile flow compared with steady flow.