Percutaneous transmyocardial revascularization induces angiogenesis: a histologic and 3-dimensional micro computed...

Area of Science:

• Cardiovascular Research
• Regenerative Medicine
• Medical Imaging

Background:

• Percutaneous transmyocardial revascularization (PTMR) is a therapeutic approach for ischemic heart disease.
• Understanding the vascularization of PTMR-created channels is crucial for optimizing treatment efficacy.

Purpose of the Study:

• To visualize the spatial patterns and vascular connections of PTMR-created channels in porcine hearts.
• To assess the acute and chronic contributions of transmyocardial and coronary perfusion.

Main Methods:

• Six pigs underwent PTMR using radiofrequency ablation.
• Three-dimensional computed tomography (3D CT) imaging was performed 1 hour post-procedure.
• Histopathology and immunohistochemistry (bFGF, VEGF) were conducted on 1-hour and 28-day specimens.

Main Results:

• PTMR channels acutely connected to myocardial capillaries and epicardial vessels.
• Chronic examination (28 days) revealed neovascularization and microvessel networks originating from channel remnants.
• Intense bFGF and VEGF expression indicated active angiogenesis.

Conclusions:

• PTMR facilitates direct vascular connections acutely and promotes angiogenesis chronically.
• These findings elucidate the vascular integration of PTMR channels, supporting its role in myocardial perfusion.