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Coarctation-induced degenerative abdominal aortic aneurysm in a porcine model  Pao-Yen Lin, MD, Yeng-Ting Wu, MS, Guan-Cheng Lin, BS, Yao Hsiang Shih,

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Presentation on theme: "Coarctation-induced degenerative abdominal aortic aneurysm in a porcine model  Pao-Yen Lin, MD, Yeng-Ting Wu, MS, Guan-Cheng Lin, BS, Yao Hsiang Shih,"— Presentation transcript:

1 Coarctation-induced degenerative abdominal aortic aneurysm in a porcine model 
Pao-Yen Lin, MD, Yeng-Ting Wu, MS, Guan-Cheng Lin, BS, Yao Hsiang Shih, BS, Ariunaa Sampilvanjil, MD, Lih-Ren Chen, PhD, Yu- Jen Yang, MD, PhD, Hua-Lin Wu, PhD, Meei Jyh Jiang, PhD  Journal of Vascular Surgery  Volume 57, Issue 3, Pages e1 (March 2013) DOI: /j.jvs Copyright © 2013 Society for Vascular Surgery Terms and Conditions

2 Fig 1 Coarctation decreased pulsatility index in both proximal and distal abdominal aorta (AA) segments. A, Location of coarctation at an infrarenal AA segment approximately 2 cm proximal to the iliac bifurcation. An 8-mm-long expanded polytetrafluoroethylene strip was used to encircle the infrarenal AA segment with a nonconstrictive inlet and a constrictive outlet. B, Transit time flowmeter system used during operation to simultaneously monitor changes in flow, pressure, and pulsatility index at regions proximal and distal to the coarctation. Values were expressed as mean ± standard error of the mean (sham, n = 4; coarctation: n = 8). CIA, Common iliac artery; RA, renal artery. ***P < .005 vs sham group. Journal of Vascular Surgery  , e1DOI: ( /j.jvs ) Copyright © 2013 Society for Vascular Surgery Terms and Conditions

3 Fig 2 Coarctation-induced turbulent flow in the distal abdominal aorta (AA) segment. Duplex ultrasound scanning was conducted during the coarctation procedure to monitor flow patterns in both proximal and distal AA segments. Ultrasound scanning images showed a mosaic flow pattern in the distal AA segment after coarctation and a lamellar flow pattern in the proximal AA segment and sham control. Doppler spectral analysis indicated decreased peak systolic flow and increased reverse flow after coarctation, whereas sham operation had little effect on flow pattern. Journal of Vascular Surgery  , e1DOI: ( /j.jvs ) Copyright © 2013 Society for Vascular Surgery Terms and Conditions

4 Fig 3 Outer diameter and lumen perimeter of the distal abdominal aorta (AA) segment increased after coarctation. A, Representative duplex ultrasound scanning images showing increased lumen size in the distal AA segment at 12 weeks (12w) postcoarctation before sacrifice and uniform lumen in the sham group. B, Outer diameter of proximal and distal AA segments was measured after isolation of AA in the retroperitoneum. The ratio of distal-to-proximal AA diameter was calculated. **P < .01, ***P < .001 vs sham group. C and D, Hematoxylin-eosin staining of the distal AA segment (cross section) from sham group and experimental group at 4 weeks (4w), 8 weeks (8w), and 12 weeks (12w) postcoarctation. C, Representative results. Scale bar: 1000 μm. D, Lumen perimeter ratio of distal-to-suprarenal AA segment. Lumen perimeter ratio at 12w postcoarctation increased compared with sham group (P < .05). AL, Aortic lumen; CIA, common iliac artery; SA, spinal artery. Journal of Vascular Surgery  , e1DOI: ( /j.jvs ) Copyright © 2013 Society for Vascular Surgery Terms and Conditions

5 Fig 4 Changes in elastic lamella and collagen fibers in coarctation-induced abdominal aortic aneurysm (AAA). Elastic fibers (A and B) and collagen fibers (C and D) in the distal AA segment (cross section) from the sham group and experimental groups of 4 weeks (4w), 8 weeks (8w), and 12 weeks (12w) postcoarctation were examined. Elastic fibers were examined with Verhoeff-van Gieson staining. Collagen fibers were examined with Masson trichrome staining. A and C, Representative results. Scale bar: 200 μm. B and D, Relative abundance of elastic lamella (B) and collagen fibers (D). Values are given as mean ± standard error of the mean (B, n = 4∼8; D, n = 3∼4). *P <.05 vs sham. Journal of Vascular Surgery  , e1DOI: ( /j.jvs ) Copyright © 2013 Society for Vascular Surgery Terms and Conditions

6 Fig 5 Smooth muscle cell density decreased during abdominal aortic aneurysm (AAA) formation. A and B, Smooth muscle abundance in the distal abdominal aorta (AA) segment of sham group (a) and experimental groups of 4 weeks (4w; b), 8 weeks (8w; c and e), and 12 weeks (12w; d and f) postcoarctation was assessed with smooth muscle-specific α-actin (SMA)-positive area. A, Representative results. Scale bars: 200 μm (a-d); 50 μm (e and f). B, The SMA-positive area is presented as mean ± standard error of the mean (n = 3∼6). C, Cross sections of the distal AA segment from various groups stained with SMA immunofluorescence and Hoechst Smooth muscle cell nuclei were counted in the media and nuclear density presented as mean ± standard error of the mean (n = 4∼8). Journal of Vascular Surgery  , e1DOI: ( /j.jvs ) Copyright © 2013 Society for Vascular Surgery Terms and Conditions

7 Fig 6 Matrix metalloproteinase (MMP)-9 activity increased during abdominal aortic aneurysm (AAA) formation. Activity of MMP-2 and MMP-9 was assessed by gelatin zymography in the distal AA segment of the control group and the coarctation groups at 4 weeks (4w), 8 weeks (8w), and 12 weeks (12w) postcoarctation. Tissue homogenates (30 μg of protein) were separated with sodium dodecyl sulfate-polyacrylamide gel electrophoresis containing gelatin, renatured, and incubated. Enzyme activity was detected as clear bands following Coomassie blue staining and destaining. A, Representative results. B, Quantitative results expressed as mean ± standard error of the mean (n = 3∼5). *P < .05 vs sham. Journal of Vascular Surgery  , e1DOI: ( /j.jvs ) Copyright © 2013 Society for Vascular Surgery Terms and Conditions

8 Appendix Fig (online only)
Structural features of the suprarenal and proximal abdominal aortic segments following coarctation. Cross sections of the suprarenal (A, C, E) and proximal abdominal aorta (AA) (B, D, F) segments were stained for elastic fibers (A and B), collagen fibers (C and D), and smooth muscle-specific α-actin (SMA) and nucleus (E and F). The percent area of elastic fibers and collagen fibers was analyzed in four sections with four fields per section as described in the Methods. Results were presented as mean ± standard error of the mean (elastic staining, n = 3∼9; collagen staining, n = 3∼4). The SMA-positive area was used to define the media, and the number of nuclei in five or six fields of the media was counted. Nuclear density was calculated and presented as mean ± standard error of the mean (n = 3∼8). Journal of Vascular Surgery  , e1DOI: ( /j.jvs ) Copyright © 2013 Society for Vascular Surgery Terms and Conditions

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