Author + information
- Georgios Sideris1,
- Nikolaos Magkoutis2,
- Demetris Yannopoulos3,
- Chantal Kang4,
- Sebastian Voicu5,
- Jean Guillaume Dillinger6,
- Patrick Henry7 and
- Ludovic Drouet8
- 1Lariboisiere Hospital, PARIS, France
- 2Lariboisiere hospital, Paris, France
- 3University of Minnesota, Minneapolis, Minnesota, United States
- 4XP-MED, SAINT GERMAIN EN LAYE, France
- 5Lariboisiere CHU, Paris, paris, France
- 6Gh Lariboisiere Fernand Widal, Paris, France
- 7Lariboisiere CHU, Paris, PARIS, France
- 82 Thrombosis and Atherosclerosis Research Unit, Vessels and Blood Institute (IVS), Anticoagulation Clinic (CREATIF), Lariboisiere Hospital and Paris VII University EA 7334 REMES, Paris, France, paris, France
We sought to develop a reproducible, percutaneous basic science and translational animal model for the generation of thrombotic occlusion acute myocardial infarction (AMI) in adult atherosclerotic pigs to simulate human conditions.
A vascular coil COOK TORNADO® (COOK MEDICAL) 38 inches (3-3.5 x 20-50 mm) was placed in the right coronary artery (RCA) or the left anterior descending artery (LAD) in 26 downsized spontaneously hypercholesterolemic pigs and left untreated until a thrombotic intracoronary occlusion was present. After the angiographic confirmation of total occlusion, we proceeded to crossing the newly formed thrombotic occlusion with a guidewire J ES, followed by pre-dilatation with a semi compliant balloon, thrombus visualization with Optical Coherence Tomography (OCT) imaging and, finally, deployment of a stent and repeated OCT. After revascularization, we calculated the index of microcirculatory resistance (IMR) in order to estimate microvascular obstruction. AMI was confirmed by ECG, biochemical, histological, macroscopic examination and TTC imaging in all animals.
After a feasibility phase (6 animals), acute thrombotic occlusion was achieved in all 20 pigs. Eighteen animals were successful revascularized and survived until the previously selected time for sacrifice. Time to occlusion after coil placement was 69±29 min, thrombus formation was confirmed by OCT images, thrombin-antithrombin complexes (TAT) measurements and pathology examination. Myocardial necrosis was confirmed by troponin I elevation, myocardial staining and pathology examination. Distal thrombotic embolization and microvascular obstruction were supported by increased IMR and pathology examination.
A porcine model of thrombotic occlusion AMI in miniaturized adult spontaneously atherosclerotic pigs is feasible by percutaneous intracoronary placement of a coil. The reperfusion by angioplasty completed this model which mirrors human pathological conditions with myocardial infarction, necrosis and distal embolization in atherosclerotic adult pigs. Our model closely simulates human presentation of AMI and can be used to evaluate antithrombotic agents and primary angioplasty techniques.
CORONARY: Acute Myocardial Infarction