Development of a Porcine Model of Coronary Stenosis Using Fully Percutaneous Techniques Suitable For Performing Cardiac Computed Tomography, CT-Perfusion Imaging and Fractional Flow Reserve.


Journal

Heart, lung & circulation
ISSN: 1444-2892
Titre abrégé: Heart Lung Circ
Pays: Australia
ID NLM: 100963739

Informations de publication

Date de publication:
Aug 2019
Historique:
received: 09 01 2018
revised: 18 06 2018
accepted: 26 06 2018
pubmed: 29 7 2018
medline: 18 12 2019
entrez: 29 7 2018
Statut: ppublish

Résumé

The aim of this study was to develop and describe percutaneous coronary angiographic techniques to create a porcine model of acute coronary stenosis with methacrylate plugs that can by assessed using fractional flow reserve (FFR), invasive coronary angiography and coronary computed tomographic (CT) perfusion imaging without introducing artefacts associated with surgical models. Following animal care and institutional approval and using percutaneous coronary catheterisation techniques within an animal laboratory we introduced precision drilled methacrylate plugs into one of the three main coronary arteries of 10 experimental female pigs. Coronary pressure wire measurements were performed across the experimental stenosis for the calculation of FFR. Invasive coronary angiograms were obtained in stenosed arteries. Animals were transported to a dual source CT scanner (Siemens Healthcare, Forcheim, Germany) and CT perfusion imaging was performed. Ten (10) pigs were investigated with seven data sets obtained. Three (3) pigs expired prior to CT imaging secondary to pneumothorax, high grade coronary stenosis with induced cardiac arrhythmia and iatrogenic air embolism. Graded coronary stenosis was produced in six pigs in the LAD (2), LCX (2) and RCA (2) territories and one animal served as a control. Fractional flow reserve ranged from 0.21 to 0.91. Myocardial blood flow derived from dynamic CT perfusion imaging ranged from 3.5 to 136.7ml/100ml of tissue/minute. No artefacts from the deployment of the methacrylate plug, nor the plug itself, were identified. Fully percutaneous preparation of a pig model of acute coronary stenosis is feasible and provides subjects for imaging that are free of surgically induced artefact. This technique is substantially less expensive than surgically induced coronary stenosis and can be performed using standard catheterisation techniques with mobile imaging equipment. The technique is extendable to produce multivessel acute coronary stenosis and can be used for multimodality imaging.

Sections du résumé

BACKGROUND BACKGROUND
The aim of this study was to develop and describe percutaneous coronary angiographic techniques to create a porcine model of acute coronary stenosis with methacrylate plugs that can by assessed using fractional flow reserve (FFR), invasive coronary angiography and coronary computed tomographic (CT) perfusion imaging without introducing artefacts associated with surgical models.
METHODS METHODS
Following animal care and institutional approval and using percutaneous coronary catheterisation techniques within an animal laboratory we introduced precision drilled methacrylate plugs into one of the three main coronary arteries of 10 experimental female pigs. Coronary pressure wire measurements were performed across the experimental stenosis for the calculation of FFR. Invasive coronary angiograms were obtained in stenosed arteries. Animals were transported to a dual source CT scanner (Siemens Healthcare, Forcheim, Germany) and CT perfusion imaging was performed.
RESULTS RESULTS
Ten (10) pigs were investigated with seven data sets obtained. Three (3) pigs expired prior to CT imaging secondary to pneumothorax, high grade coronary stenosis with induced cardiac arrhythmia and iatrogenic air embolism. Graded coronary stenosis was produced in six pigs in the LAD (2), LCX (2) and RCA (2) territories and one animal served as a control. Fractional flow reserve ranged from 0.21 to 0.91. Myocardial blood flow derived from dynamic CT perfusion imaging ranged from 3.5 to 136.7ml/100ml of tissue/minute. No artefacts from the deployment of the methacrylate plug, nor the plug itself, were identified.
CONCLUSIONS CONCLUSIONS
Fully percutaneous preparation of a pig model of acute coronary stenosis is feasible and provides subjects for imaging that are free of surgically induced artefact. This technique is substantially less expensive than surgically induced coronary stenosis and can be performed using standard catheterisation techniques with mobile imaging equipment. The technique is extendable to produce multivessel acute coronary stenosis and can be used for multimodality imaging.

Identifiants

pubmed: 30054125
pii: S1443-9506(18)31801-8
doi: 10.1016/j.hlc.2018.06.1050
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

1292-1300

Informations de copyright

Copyright © 2018 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). Published by Elsevier B.V. All rights reserved.

Auteurs

Rohan Poulter (R)

Division of Cardiology, Vancouver General Hospital, Vancouver, British Columbia, Canada. Electronic address: rohan.poulter@health.qld.gov.au.

David A Wood (DA)

Division of Cardiology, Vancouver General Hospital, Vancouver, British Columbia, Canada.

Andrew Starovoytov (A)

Division of Cardiology, Vancouver General Hospital, Vancouver, British Columbia, Canada.

Stephanie Smith (S)

Jack Bell Research Centre, Vancouver General Hospital, Vancouver, British Columbia, Canada.

Mehran Chitsaz (M)

Department of Radiology, Vancouver General Hospital, Vancouver, British Columbia, Canada.

John Mayo (J)

Division of Cardiology, Vancouver General Hospital, Vancouver, British Columbia, Canada; Department of Radiology, Vancouver General Hospital, Vancouver, British Columbia, Canada.

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Classifications MeSH