Evaluation of thrombolysis and angioplasty in a porcine iliac artery thrombosis model: application of endovascular stent-graft-induced thrombosis.
OBJECTIVE
To develop a novel endovascular thrombosis model in the porcine iliac artery for the evaluation of thrombolysis and angioplasty.


METHODS
A stent-inversion-graft (SIG) model combining either a 3-mm or 5-mm tapered expandable polytetrafluoroethylene (ePTFE) graft attached within a self-expandable, 10-mm nitinol stent was placed in the left common iliac artery via an ipsilateral common femoral artery approach in 24 pigs. When the iliac artery was thrombosed, urokinase (250,000 IU) plus heparin (1,000 units) were pulse sprayed via a contralateral femoral approach (n = 12). Saline pulse-spray was used as a control group (n = 12). Balloon angioplasty was performed to eliminate the stenotic tapered graft within the stent after successful thrombolysis. The efficacy of the thrombolysis was assessed with use of intravascular ultrasound (IVUS) and arteriogram.


RESULTS
Both the 3-mm tapered and 5-mm tapered SIG models caused iliac artery occlusion in 22 +/- 5 and 41 +/- 9 minutes, respectively, after the deployment. Luminal patency was re-established successfully in all occluded arteries after urokinase infusion. Angioplasty was successful in eliminating the tapered stenosis and restoring the normal diameter in all iliac arteries treated with urokinase. Complete thrombolysis was achieved in both models treated with urokinase.


CONCLUSIONS
This novel endovascular approach of inducing arterial thrombosis is simple to perform and reliably produces arterial thrombosis. The intraluminal stenosis is also amenable to angioplasty. This model is useful for the evaluation of antithrombotic treatment modality and adjunctive endovascular interventions.
Lin
P H
PH
Department of Surgery, Emory University School of Medicine, Atlanta, Georgia 30322, USA.
Surowiec
S M
SM
Conklin
B
B
Chen
C
C
Bush
R
R
Weiss
V J
VJ
Lumsden
A B
AB
D000497:Alloys; D000792:Angiography; D000800:Angioplasty, Balloon; D000818:Animals; D000925:Anticoagulants / Q000008:administration & dosage*; D001672:Biocompatible Materials; D001807:Blood Vessel Prosthesis; D004195:Disease Models, Animal; D006083:Graft Occlusion, Vascular / Q000150:complications / Q000175:diagnosis / Q000628:therapy*; D006493:Heparin / Q000008:administration & dosage*; D007083:Iliac Artery / Q000000981:diagnostic imaging / Q000473:pathology; D007269:Injections, Intra-Arterial; D010960:Plasminogen Activators / Q000008:administration & dosage*; D011138:Polytetrafluoroethylene; D011475:Prosthesis Failure; D013552:Swine; D015912:Thrombolytic Therapy / Q000379:methods*; D013927:Thrombosis / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D018084:Ultrasonography, Interventional; D014568:Urokinase-Type Plasminogen Activator / Q000008:administration & dosage*
D000497:Alloys; D000925:Anticoagulants; D001672:Biocompatible Materials; C013616:nitinol; D011138:Polytetrafluoroethylene; D006493:Heparin; D010960:Plasminogen Activators; D014568:Urokinase-Type Plasminogen Activator