Background
The aim of this study was to develop and describe percutaneous coronary angiographic
techniques to create a porcine model of acute coronary stenosis with methacrylate
plugs that can by assessed using fractional flow reserve (FFR), invasive coronary
angiography and coronary computed tomographic (CT) perfusion imaging without introducing
artefacts associated with surgical models.
Methods
Following animal care and institutional approval and using percutaneous coronary catheterisation
techniques within an animal laboratory we introduced precision drilled methacrylate
plugs into one of the three main coronary arteries of 10 experimental female pigs.
Coronary pressure wire measurements were performed across the experimental stenosis
for the calculation of FFR. Invasive coronary angiograms were obtained in stenosed
arteries. Animals were transported to a dual source CT scanner (Siemens Healthcare,
Forcheim, Germany) and CT perfusion imaging was performed.
Results
Ten (10) pigs were investigated with seven data sets obtained. Three (3) pigs expired
prior to CT imaging secondary to pneumothorax, high grade coronary stenosis with induced
cardiac arrhythmia and iatrogenic air embolism. Graded coronary stenosis was produced
in six pigs in the LAD (2), LCX (2) and RCA (2) territories and one animal served
as a control. Fractional flow reserve ranged from 0.21 to 0.91. Myocardial blood flow
derived from dynamic CT perfusion imaging ranged from 3.5 to 136.7 ml/100 ml of tissue/minute. No artefacts from the deployment of the methacrylate plug, nor
the plug itself, were identified.
Conclusions
Fully percutaneous preparation of a pig model of acute coronary stenosis is feasible
and provides subjects for imaging that are free of surgically induced artefact. This
technique is substantially less expensive than surgically induced coronary stenosis
and can be performed using standard catheterisation techniques with mobile imaging
equipment. The technique is extendable to produce multivessel acute coronary stenosis
and can be used for multimodality imaging.
Keywords
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Article info
Publication history
Published online: July 10, 2018
Accepted:
June 26,
2018
Received in revised form:
June 18,
2018
Received:
January 9,
2018
Identification
Copyright
© 2018 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). Published by Elsevier B.V. All rights reserved.
