Endovascular aneurysmal models at the external iliac artery of dogs

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Endovascular aneurysmal models at the external iliac artery of dogs Kenichi Matsunaga, MD, Chiaki Takasawa, MD, Kazumasa Seiji, MD, Kei Takase, MD, Shoki Takahashi, MD, Toshio Matsuhashi, MD, Yasuhiro Nakamura, MD, Fumiyoshi Fujisihima, MD  Journal of Vascular Surgery  Volume 55, Issue 6, Pages 1742-1748 (June 2012) DOI: 10.1016/j.jvs.2011.11.056 Copyright © 2012 Society for Vascular Surgery Terms and Conditions

Fig 1 Diagrams illustrate the division of the dogs into S, E, B+S, and B+E groups. In all groups, a double-balloon catheter was used to create a closed cavity by the external iliac artery (EIA). 1, In groups without balloon dilation (n = 8), S group: The closed cavity at the right EIA was filled with saline. E group: The closed cavity at the left EIA was filled with elastase. 2, With balloon dilation (n = 8). B+S group: The right EIA was expanded with a balloon catheter and the closed cavity filled with saline. B+E group: The left EIA was expanded with a balloon catheter and the closed cavity was filled with elastase. Journal of Vascular Surgery 2012 55, 1742-1748DOI: (10.1016/j.jvs.2011.11.056) Copyright © 2012 Society for Vascular Surgery Terms and Conditions

Fig 2 Diagrams show (a) vessel inner circumference, (b) positive finding length, (c) and disappearance or degeneration of the normal structure. Above vessel inner circumference and positive finding length of a tissue specimen, Elastica-Masson staining, were measured using ImageJ. Positive findings were calculated using the following formula: b/a. Journal of Vascular Surgery 2012 55, 1742-1748DOI: (10.1016/j.jvs.2011.11.056) Copyright © 2012 Society for Vascular Surgery Terms and Conditions

Fig 3 Histologic findings percentage and the inner vasodilation ratio are shown for each dog of each group. Journal of Vascular Surgery 2012 55, 1742-1748DOI: (10.1016/j.jvs.2011.11.056) Copyright © 2012 Society for Vascular Surgery Terms and Conditions

Fig 4 The graph shows the inner vasodilation ratio of the external iliac artery (EIA), defined as the ratio of postoperative to preoperative inner diameters in each group. In the B+E group, the EIA was significantly dilated compared with that in other groups (P < .05). S group, A closed cavity made by a double-balloon catheter at the EIA is filled with saline. B+S group, The EIA is expanded with a balloon catheter and a closed cavity made by a double-balloon catheter is filled with saline. E group, A closed cavity made by a double-balloon catheter at the EIA is filled with elastase. B+E group, The EIA is expanded with a balloon catheter and a closed cavity made by a double-balloon catheter is filled with elastase. Journal of Vascular Surgery 2012 55, 1742-1748DOI: (10.1016/j.jvs.2011.11.056) Copyright © 2012 Society for Vascular Surgery Terms and Conditions

Fig 5 Digital subtraction angiography at 4 weeks after balloon dilation and elastase or saline injection shows enlargement of the external iliac artery (EIA) that received elastase (left) but no significant dilation in the artery that received saline (right). Journal of Vascular Surgery 2012 55, 1742-1748DOI: (10.1016/j.jvs.2011.11.056) Copyright © 2012 Society for Vascular Surgery Terms and Conditions

Fig 6 Macroscopic evaluation of the external iliac artery (EIA) in the balloon-dilation groups. The EIA in dogs that received elastase injection group (left: yellow arrow) is obviously dilated, whereas the EIA in those that received saline injection (right: blue arrow) is only minimally dilated. Journal of Vascular Surgery 2012 55, 1742-1748DOI: (10.1016/j.jvs.2011.11.056) Copyright © 2012 Society for Vascular Surgery Terms and Conditions

Fig 7 Histologic findings in each group. A, Disappearance of the internal elastic lamina is significantly pronounced in the E group compared with the S group (P < .05). Disappearance of the internal elastic lamina is significantly pronounced in the B+E group compared with the B+S and S groups (P < .05). B, Degeneration and disappearance of medial smooth muscle is observed in the B+S and B+E groups, which is not significantly different from the other groups. C, Degeneration and disappearance of the external elastic lamina is significantly pronounced in the B+E group compared with the other groups (P < .05). D, Neointimal thickening is observed in the E, B+S, and B+E groups, but no significant difference is noted among them. S group, A closed cavity is created at the external iliac artery (EIA) and is filled with saline. B+S group, The EIA undergoes balloon dilation and a closed cavity made by a double-balloon catheter is filled with saline. E group, A closed cavity is created at the EIA and is filled with elastase. B+E group, The EIA undergoes balloon dilation and a closed cavity made by a double-balloon catheter is filled with elastase. Journal of Vascular Surgery 2012 55, 1742-1748DOI: (10.1016/j.jvs.2011.11.056) Copyright © 2012 Society for Vascular Surgery Terms and Conditions

Fig 8 Histologic findings at Elastica-Mason staining of each group (left is original magnification, × 20 and right is original magnification, × 100) regarding the disappearance of the internal elastic lamina, degeneration and disappearance of medial smooth muscle and the external elastic lamina, and neointimal thickening in the external iliac artery (EIA). A, S group, received saline injection and EIA shows normal histologic findings. B, B+S group, The EIA undergoes balloon dilation and a closed cavity made by a double-balloon catheter is filled with saline. The EIA shows disappearance of the internal elastic lamina (white arrows), degeneration and disappearance of medial smooth muscle (*), and neointimal thickening (arrowhead) but no degeneration and disappearance of the external elastic lamina. C, E group, The EIA undergoes balloon dilation and a closed cavity made by a double-balloon catheter is injected with elastase. The EIA shows disappearance of the internal elastic lamina (white arrow), degeneration and disappearance of the external elastic lamina (circle), and neointimal thickening (blue arrow), but no degeneration and disappearance of medial smooth muscle. D, B+E group, The EIA undergoes balloon dilation and a closed cavity made by a double-balloon catheter is filled with elastase at the left EIA. The EIA shows disappearance of the internal elastic lamina (white arrows), degeneration and disappearance of the external elastic lamina (circle), degeneration and disappearance of medial smooth muscle (*), and neointimal thickening (arrowhead). Journal of Vascular Surgery 2012 55, 1742-1748DOI: (10.1016/j.jvs.2011.11.056) Copyright © 2012 Society for Vascular Surgery Terms and Conditions