Oesophageal mucosal blood flow changes after thoracic endovascular stent graft implantation using a novel sensor probe†
Oesophageal mucosal blood flow changes after thoracic endovascular stent graft implantation using a novel sensor probe†
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使用新型传感器探头进行胸腔血管内覆膜支架植入后食管粘膜血流变化†
DOI：
10.1093/icvts/ivx351
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发表时间：
2018
影响因子：
--
通讯作者：
Saiki Yoshikatsu
中科院分区：
文献类型：
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作者：
Katahira Shintaro;Kawamoto Shunsuke;Masaki Naoki;Hayatsu Yukihiro;Matsunaga Tadao;Haga Yoichi;Saiki Yoshikatsu
继发性食管瘘是一种罕见的，致命的并发症发生在胸部血管内瘘修复术后。继发性食道瘘管的原因尚不清楚，但局部食道粘膜血流量（OMBF）的减少可能是这种毁灭性后遗症的基础。我们的研究旨在开发一种新的血流传感器探头，以检测OMBF的变化后，胸部支架移植物植入在一个实验猪model.METHODSA新的激光多普勒血流传感器探头结合光纤传感器内的鼻胃管，采用微机电系统技术。使用该传感器探针测量不同水平的OMBF，以测试在6只猪中覆盖Th 4-Th 8椎骨水平的胸血管内支架移植物植入之前和之后的OMBF的可行性。胸段血管内覆膜支架植入后测量的OMBF较基线显著降低（8.6 ± 2.7 vs 18.4 ± 7.9 ml/min/100 g，P< 0.0001），支架植入术后至少2 h出现平台期（8.7 ± 3.3 ml/min/100 g，P< 0.0001 vs基线）。OMBF在上（Th 1-Th 3）和下（Th 9-Th 11）食管，主动脉未覆盖支架移植物，不受胸血管内支架移植术的影响。CONCLUSIONSThe新颖的激光多普勒血流传感器探头是有用的监测OMBF在猪模型中的精确变化，证明了胸血管内支架移植物植入后OMBF显着减少。
OBJECTIVESSecondary aorto-oesophageal fistula is a rare, lethal complication occurring after thoracic endovascular aneurysmal repair. The cause of secondary aorto-oesophageal fistula is unknown, but a reduction in local oesophageal mucosal blood flow (OMBF) may be a basis for such a devastating sequela. Our study aims to develop a novel blood flow sensor probe to detect changes in OMBF after thoracic stent graft implantation in an experimental swine model.METHODSA novel laser Doppler flowmetry sensor probe incorporating an optical fibre sensor within a nasogastric tube was developed using microelectromechanical system technology. OMBF was measured at various levels using this sensor probe, to test its feasibility before and after thoracic endovascular stent graft implantation covering Th4–Th8 vertebral levels in 6 swine.RESULTSIn the middle oesophagus (Th5–Th7), where the aorta was covered with a stent graft, the measured OMBFs were significantly decreased after thoracic endovascular stent graft implantation than those of baseline (8.6 ± 2.7 vs 18.4 ± 7.9 ml/min/100 g,P< 0.0001), followed by a plateau period for at least 2 h after stent grafting (8.7 ± 3.3 ml/min/100 g,P< 0.0001 vs baseline). OMBFs in the upper (Th1–Th3) and lower (Th9–Th11) oesophagus, where the aorta was not covered with a stent graft, were unaffected by thoracic endovascular stent grafting.CONCLUSIONSThe novel laser Doppler flowmetry sensor probe was useful to monitor precise changes of OMBF in a swine model, demonstrating a significant reduction in OMBF after thoracic endovascular stent graft implantation.