The Official Journal of EuroPCR and the European Association of Percutaneous Coronary Interventions (EAPCI)

CORONARY INTERVENTIONS

A novel experimental thrombotic myocardial infarction and primary angioplasty model in swine

EuroIntervention 2019;14:e1843-e1851 published online June 2018. DOI: 10.4244/EIJ-D-17-00763

1. Department of Cardiology - Inserm U942, Lariboisiere Hospital, AP-HP, Paris Diderot University, Paris, France; 2. Department of Medical and Toxicological Intensive Care - Inserm U1144, Lariboisiere Hospital, APHP, Paris Diderot University, Paris, France; 3. CR2I-INRA, Jouy en Josas, France; 4. Alpina European Research Institute - A.E.R.I, Archamps, France; 5. University of Minnesota, Cardiovascular Division, Minneapolis, MN, USA; 6. Thrombosis and Atherosclerosis Research Unit, Vessels and Blood Institute (IVS), Anticoagulation Clinic (CREATIF), Lariboisiere Hospital and Paris VII University EA 7334 REMES, Paris, France; 7. Pathology Department, Lariboisiere Hospital, Paris, France; 8. CHUV, Institut Universitaire de Pathologie, Lausanne, Switzerland

Aims: We sought to develop a reproducible animal model for acute myocardial infarction (AMI) in adult atherosclerosis-prone pigs.

Methods and results: A coil was placed in the right coronary artery or the left anterior descending artery in 26 downsized spontaneously hypercholesterolaemic pigs and left untreated until thrombotic occlusion. Then, we crossed the thrombotic occlusion with a guidewire, followed by predilatation, thrombus visualisation with optical coherence tomography (OCT) imaging and, finally, deployment of a stent and repeated OCT. After revascularisation, we calculated the index of microcirculatory resistance (IMR). After a feasibility phase (six animals), acute thrombotic occlusion was achieved in all 20 pigs. Eighteen animals were successfully revascularised and survived until sacrifice. Thrombus formation was confirmed by OCT, measurement of thrombin-antithrombin complexes and pathology examination. Myocardial necrosis was confirmed by troponin T elevation, myocardial staining and pathology examination. Distal thrombotic embolisation and microvascular obstruction were supported by increased IMR and pathology examination.

Conclusions: A porcine model of thrombotic occlusion AMI in miniaturised adult spontaneously atherosclerosis-prone 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 embolisation.

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