Challenging the surgical rodent hindlimb ischemia model with the miniinterventional technique

Purpose

To develop an interventional hindlimb ischemic model and compare its angiogenic effect versus surgical ligation (SL) and excision of the femoral artery in rats treated with transplantation of bone marrow mononuclear cells (MNCs) as an angiogenic stimulator.

Materials and Methods

Forty-eight Lewis rats randomly received interventional embolization (IE) with hydrogel wire or SL and excision of the right femoral artery. Rodents were intraarterially transplanted with 1.5 × 10⁷ MNCs in 500 μL medium from 24 isogenic donor rats. Functional and structural recovery was evaluated by laser Doppler imaging (LDI), cytokine/chemokine assay, and histologic staining.

Results

In vivo microscopic images showed significantly dilated vasa vasorum around the embolized segment of the right femoral artery at 3 days compared with disorganized tissue structure in the SL group. However, the LDI index was significantly higher in the SL group at 3 days compared with the IE group. LDI did not significantly differ between the two groups at 2 weeks after transplantation. Cytokine assay showed higher levels of interleukin (IL)–1α and IL-18 in the SL group; the IE group had higher levels of interferon-γ, IL-6, IL-13, and granulocyte colony-stimulating factor. Histologic examination demonstrated inflammatory infiltration near the incision within nerve fibers with dilated capillaries, showing nerve degeneration in the SL group. At 2 weeks, histologic analysis demonstrated massive scarring under the skin spreading into the musculature in the SL group.

Conclusions

A minimally invasive hindlimb ischemia model has been successfully developed that preserves tissue integrity and minimizes inflammation and confounding factors in the early stages of angiogenesis and arteriogenesis.     

二尖瓣成形术治疗感染性心内膜炎(IE)的中长期疗效

 目的  总结二尖瓣成形术治疗感染性心内膜炎(infective endocarditis,IE)的中长期疗效。方法  回顾性分析复旦大学附属中山医院心外科2005年1月至2012年12月运用二尖瓣成形术治疗单纯累及二尖瓣的IE患者28例,占同期手术治疗单纯累及二尖瓣感染性心内膜炎的24.1%。切除瓣体及瓣缘赘生物后,行缘对缘缝合2例,穿孔缝合2例,前叶植入人工腱索5例,前叶三角形切除6例,后叶楔形切除16例,植入人工二尖瓣成形环28例。结果  全组无手术死亡。术后即刻经食道超声心动图示25例无反流,3例轻微反流。随访28例,随访时间15~111 (54.7±34.2)个月,无复发,无再次手术,无死亡。术后随访经胸超声心动图,随访时间1~87 (26.6±27.9)个月,无反流9例,轻微反流18例,轻中度反流1例。结论  二尖瓣成形术治疗二尖瓣IE具有满意的中长期疗效。对于二尖瓣结构未被严重破坏的IE患者,可尝试二尖瓣成形术。