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Published on: March 27, 2018
A Novel Porcine Model of Bilateral Hindlimb Bypass Graft Surgery Integrating Transit Time Flowmetry
Andrew B Haymet1,2, Cora Lau3, Christina Cho3
1Critical Care Research Group, The Prince Charles Hospital, L1 Clinical Sciences Building, Chermside, QLD, 4032, Australia. a.haymet@gmail.com.
Insights
This study presents a new pig model for studying bypass graft failure. The model successfully demonstrated graft patency using transit time flowmetry, offering a platform for future research into graft occlusion.
Area of Science:
- Vascular Surgery
- Surgical Innovation
- Animal Models
Background:
- Bypass graft surgery is crucial for treating ischemic heart and limb disease.
- Graft occlusion is a significant clinical challenge in bypass procedures.
- Understanding graft failure mechanisms is vital for developing new therapies.
Purpose of the Study:
- To establish and validate a preclinical animal model for investigating bypass graft failure.
- To assess the feasibility of using transit time flowmetry in a bilateral graft model.
Main Methods:
- A bilateral external jugular vein to femoral artery bypass model was created in three pigs.
- Graft patency was assessed intraoperatively and on postoperative day three.
- Transit time flowmetry (Medistim MiraQ system) was employed for graft assessment.
Main Results:
- All six performed bypass grafts were patent (100%) immediately post-surgery.
- Graft patency was confirmed at postoperative day three using transit time flowmetry.
- The surgical model demonstrated successful graft creation and assessment.
Conclusions:
- This bilateral graft model provides a robust platform for studying graft failure pathobiology.
- The combination of this model with transit time flowmetry allows for objective, longitudinal studies.
- This approach can facilitate the development of targeted interventions to prevent graft failure.
Background:
Bypass graft surgery is a key surgical intervention for ischemic heart disease (coronary bypass graft surgery) and critical limb ischemia (peripheral bypass graft surgery). Graft occlusion remains a significant clinical problem for both types. Further research into the pathobiological mechanisms of graft occlusion are needed in order to design targeted therapeutic strategies.
Methods:
Three Large White female pigs (mean weight 52.3 +/- 4.4 kg) received general anaesthesia prior to surgery. The external jugular vein was harvested bilaterally, and a bilateral femoral peripheral arterial bypass was performed, with the superficial femoral artery permanently ligated. The grafts were interrogated immediately post operatively on-table using Medistim MiraQ transit time flowmetry system (Medistim, Oslo, Norway) to assess graft performance. On postoperative day three, the pigs were returned to the operating room, and the grafts were interrogated once again using transit time flowmetry.
Results:
Six out of six (100%) successful bilateral EJV to femoral artery bypass grafts were performed. All pigs were successfully recovered, and returned to the operating room at postoperative day 3. The wounds were re-opened and the grafts were inspected. Postoperative graft assessment was performed with transit time flowmetry using the Medistim MiraQTM system (Medistim, Oslo, Norway), demonstrating all grafts were patent (100%).
Conclusion:
This model may serve as a platform to gain further mechanistic insight into graft failure pathobiology. By combining a bilateral graft model with gold-standard transit time flowmetry, longitudinal experimentation of targeted therapeutic interventions to combat graft failure may be further studied with improved objectivity.
