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目的 制作犬颈内动脉的选择性灌注模型 ,验证可取出式动脉滤器对犬脑的保护效率。方法 健康杂种犬 12只 ,随机分为滤器组及对照组。以明胶海绵栓塞颈外动脉 ,制作犬颈内动脉的选择性灌注模型。滤器组每只犬于颈总动脉内滤器近侧注入 1mm× 1mm× 1mm大小的血栓 5个 ,对照组犬则不用滤器 ,直接注入栓子。术后观察动物神经系统功能改变情况 ,术后 2 4h行犬脑MR检查 ,术后 7d将犬脑取出、固定 ,行大体病理检查。结果 栓子注入后血管造影 ,对照组犬中 ,5只显示颈内动脉分支闭塞 ,滤器组犬均未见颈内动脉栓塞表现。对照组犬中 ,5只术中出现对侧肢体及颈部强直 ,其中 2只在注入栓子后于术中死亡 ;滤器组犬中 ,2只术后出现栓塞对侧肢体轻瘫 ,12～ 2 4h后症状消失。对照组犬中 ,4只术后MR显示栓塞侧大面积脑梗死 ;滤器组犬中 ,除 1只犬术后MR显示术侧外囊点状梗死灶外 ,其余 5只犬术后MR显示正常。术后大体病理表现与MR结果相符。结论动脉滤器对约 1mm大小的较大栓子有令人满意的捕获能力 ,能有效防止严重脑梗死并发症的发生。但此种动脉滤器对小于 1mm的栓子的捕获能力尚待进一步研究。
Objective To develop a selective perfusion model of canine internal carotid artery to verify the protective efficiency of removable arterial filter on canine brain. Methods 12 healthy hybrid dogs were randomly divided into filter group and control group. A gelatin sponge was used to embolize the external carotid artery to make a selective perfusion model of the canine internal carotid artery. Each dog in the filter group was injected with 5 × 1mm × 1mm × 1mm thrombus in the proximal part of the common carotid artery. The control dogs were injected directly with the filter without filter. The changes of nervous system function were observed after operation. The canine brain MR examination was performed 24 hours after operation. After 7 days, the canine brain was removed and fixed, and the gross pathological examination was performed. Results Angiography was performed after emboli injection. Five of the control dogs showed occlusion of the internal carotid artery, and none of the dogs in the filter group showed embolization of the internal carotid artery. In the control group, contralateral limbs and neck stiffness were found in 5 of the 5 dogs, of which 2 died after intraoperative injection of emboli. In the group of dogs in the filter group, 2 4h after the symptoms disappear. In the control group, four postoperative MR showed large infarct on the embolization side. In the filter group, except for one postoperative MR, the MR showed normal postoperative MR in the other five dogs . Postoperative gross pathology and MR results. Conclusion Arterial filters have a satisfactory ability to capture larger emboli of approximately 1 mm in size and can effectively prevent the development of severe cerebral infarction complications. However, this type of arterial filter less than 1mm emboli capture capacity remains to be further studied.