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Sheep models for evaluation of novel patch and prosthesis material in vascular surgery: tips and tricks to avoid possible pitfalls

机译：用于评估血管外科的新型贴剂和假体材料的绵羊模型：避免可能陷阱的提示和技巧

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Abstract Background In vascular surgery, novel synthetic prosthesis materials for patch-angioplasties, interpositions, bypasses and shunts are continuously under development and optimization. The characteristics of an ideal vascular prosthesis would display long-term patency, biocompatibility, durability, low porosity, lack of stich hole bleeding, ease of handling, kink resistance, infection resistance and reasonable costs. The aim of this study was to establish and report a reliable sheep model including potential pitfalls where those parameters could be analyzed. Before surgery, sheep were acclimatized for 4–8 weeks, during which parasite infections were treated and blood and serum parameters monitored. Twenty-four sheep underwent surgery, and carotid patch-angioplasties (n = 12), graft interpositions (n = 6) or arteriovenous prosthetic shunts (n = 6) were implanted. Half of the animals in each group were sacrificed after 2 weeks and the other half after 8 weeks. The implants were analyzed for patency, endothelialization, thrombogenicity and biocompatibility by clinical observation, blood flow measurement and pathological and histopathological (H&E, EvG) as well as immunohistochemical (Ki67, CD31) evaluations. Results Health monitoring of the sheep revealed a parasitic burden with endoparasites in all animals. Some animals showed thereby infestations in the bile duct causing fibrotic cholangitis with calcifications in the liver. In addition, sarcosporidia were detected in histopathological specimen of the heart in all animals. Parasitic burden correlated with blood counts and serum bilirubin levels. Both were significantly reduced by albendazole treatment within the acclimatization time. Patches, interposition grafts, and straight shunts were successfully implanted bilaterally in all animals. The total average operation time was 136 ± 21 min. Most animals (23/24) showed good patency rates and general condition after implantation. Pathological and histopathological/immunohistochemical analyses were suitable to determine thrombogenicity, endothelialization, cellular/fibroblastic proliferation, biocompatibility, inflammatory cell infiltration, and thickness of neointima in the prosthesis material. Conclusions We have developed a suitable experimental protocol with standardized and successful anesthesia- and surgical-procedures for patch-angioplasty, graft interposition, and arteriovenous prosthetic shunts. This sheep model allows testing of new prosthetic materials for biocompatibility, thrombogenicity, and endothelialization.
机译：血管外科的抽象背景，贴膜 - 血管成型，插入，旁路和分流器的新型合成假体材料在开发和优化下不断进行。理想血管假体的特点将显示长期的通畅，生物相容性，耐久性，低孔隙率，缺乏恶劣的孔出血，易于处理，扭结，感染抗性和合理的成本。本研究的目的是建立并报告可靠的绵羊模型，包括可以分析这些参数的潜在陷阱。在手术前，绵羊适应4-8周，在此期间，治疗寄生虫感染，并监测血液和血清参数。植入二十四只绵羊接受手术，和颈动脉贴膜 - 血管成型（n = 12），接枝介入（n = 6）或动静脉假体分流（n = 6）。在2周后，每组的一半动物在8周后2周后处死。通过临床观察，血流测量和病理和组织病理学（H＆E，EVG）以及免疫组化（KI67，CD31）评估，分析植入物进行通畅，内皮，血栓形成性和生物相容性。结果绵羊的健康监测揭示了所有动物内索肌腱的寄生负担。有些动物表明胆管导致肝脏胆管炎的胆管炎患者肝脏。此外，在所有动物的心脏组织病理学标本中检测到SARCOSPOLIDIA。寄生负担与血液计数和血清胆红素水平相关。在适应时间内的阿比萨唑治疗均显着降低。贴片，插入移植物和直分流器被成功植入所有动物中的双侧植入。总平均操作时间为136±21分钟。大多数动物（23/24）显示出植入后的良好的通畅率和一般情况。病理和组织病理学/免疫组织化学分析适用于测定假体材料中的血栓形成性，内皮，细胞/纤维细胞增殖，生物相容性，炎性细胞浸润和新内膜的厚度。结论我们开发了一种合适的实验方案，具有标准化和成功麻醉和外科手术程序，用于贴膜 - 血管成形术，移植物插入和动脉假体分流。该绵羊模型可以测试用于生物相容性，血栓形成性和内皮化的新的假体材料。

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