TY - JOUR
T1 - Endovascular Porcine Model of Iliocaval Venous Thrombosis
AU - Schwein, Adeline
AU - Magnus, Louis
AU - Markovits, Judit
AU - Chinnadurai, Ponraj
AU - Autry, Kyle
AU - Jenkins, Leslie
AU - Barnes, Rebecca
AU - Vekilov, Dragoslava P.
AU - Shah, Dipan
AU - Chakfé, Nabil
AU - Bismuth, Jean
N1 - Publisher Copyright:
© 2021 European Society for Vascular Surgery
PY - 2022/4
Y1 - 2022/4
N2 - Objective: To develop a large animal model of iliocaval deep venous thrombosis (DVT), which enables development and evaluation of interventional management and existing imaging modalities. Methods: The experimental protocol consisted of a total endovascular approach. Pigs were percutaneously accessed through the right internal jugular and bilateral femoral veins. Three balloon catheters were inflated to induce venous stasis in the infrarenal inferior vena cava (IVC) and bilateral common iliac veins (CIVs). Hypercoagulability was induced by injecting 10 000 IU of thrombin. After 2.5 hours, the balloon catheters were removed before animal recovery. After seven, 14, 21, 28, or 35 days, animals were euthanised; the IVC and CIV were harvested en bloc, cross sectioned and prepared for histological examination. Multimodal imaging was performed before and after thrombus creation, and before animal euthanasia. Results: Thirteen female domestic pigs with a mean weight of 59.3 kilograms were used. The mean maximum IVC diameter and area were 16.4 mm and 1.2 cm2, respectively. The procedure was successful in 12 animals with occlusive venous thrombosis in the region of interest on immediate post-operative magnetic resonance venography and a mean thrombus volume of 19.8 cm3. Clinical pathology results showed platelet consumption, D dimer increase, and inflammatory response. Histological evaluation demonstrated a red cell, fibrin, and platelet rich thrombus on day 1, with progressive inflammatory cell infiltration from day 7. Collagen deposition appeared in week 2 and neovascularisation in week 3. Conclusion: Endovascular occlusion combined with thrombin infusion is a reliable minimally invasive approach to produce acute and subacute DVT in a large animal model.
AB - Objective: To develop a large animal model of iliocaval deep venous thrombosis (DVT), which enables development and evaluation of interventional management and existing imaging modalities. Methods: The experimental protocol consisted of a total endovascular approach. Pigs were percutaneously accessed through the right internal jugular and bilateral femoral veins. Three balloon catheters were inflated to induce venous stasis in the infrarenal inferior vena cava (IVC) and bilateral common iliac veins (CIVs). Hypercoagulability was induced by injecting 10 000 IU of thrombin. After 2.5 hours, the balloon catheters were removed before animal recovery. After seven, 14, 21, 28, or 35 days, animals were euthanised; the IVC and CIV were harvested en bloc, cross sectioned and prepared for histological examination. Multimodal imaging was performed before and after thrombus creation, and before animal euthanasia. Results: Thirteen female domestic pigs with a mean weight of 59.3 kilograms were used. The mean maximum IVC diameter and area were 16.4 mm and 1.2 cm2, respectively. The procedure was successful in 12 animals with occlusive venous thrombosis in the region of interest on immediate post-operative magnetic resonance venography and a mean thrombus volume of 19.8 cm3. Clinical pathology results showed platelet consumption, D dimer increase, and inflammatory response. Histological evaluation demonstrated a red cell, fibrin, and platelet rich thrombus on day 1, with progressive inflammatory cell infiltration from day 7. Collagen deposition appeared in week 2 and neovascularisation in week 3. Conclusion: Endovascular occlusion combined with thrombin infusion is a reliable minimally invasive approach to produce acute and subacute DVT in a large animal model.
KW - Animal model
KW - Deep vein thrombosis
KW - Endovascular
KW - Experimental
KW - Vena Cava, Inferior/diagnostic imaging
KW - Humans
KW - Thrombin
KW - Treatment Outcome
KW - Venous Thrombosis/diagnostic imaging
KW - Endovascular Procedures/methods
KW - Vascular Patency/physiology
KW - Animals
KW - Swine
KW - Female
KW - Iliac Vein/diagnostic imaging
KW - Stents
KW - Disease Models, Animal
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U2 - 10.1016/j.ejvs.2021.12.022
DO - 10.1016/j.ejvs.2021.12.022
M3 - Article
C2 - 35272950
AN - SCOPUS:85125953492
SN - 1078-5884
VL - 63
SP - 623
EP - 630
JO - European Journal of Vascular and Endovascular Surgery
JF - European Journal of Vascular and Endovascular Surgery
IS - 4
ER -