Vascularização temporária de membros isquêmicos por meio de shunt arteriomedular: trabalho experimental

Abstract

Background: The authors idealized a temporary shunt between the femoral artery and the medullar canal on long bones to keep the viability of acutely ischemic limbs, while waiting for a definitive treatment. Objective: To assess the flow on temporary shunts between the femoral artery and the marrow canal of the tibia during two hours in experimental dogs, which had the femoral artery interrupted. Methods: Two groups with three dogs on the Control Group and six on the Intervention Group were allocated at random. The controls had the right femoral common artery interrupted. The Intervention Group received a shunt between the iliac external artery and the medullar canal of the right tibia in addition. After two hours, the measure of the pH, blood coloration, blood flow in sonar Doppler on the ischemic limbs were performed. The lungs were withdrawn in thoracic block for anatomic-pathologic analyses. Results: The capillary blood pH average of the limb extremities in the Control Group was 6.97 (±0.39) and in the Intervention Group was 7.25 (±0.46), with p<0.001, and the blood coloration in the Intervention Group kept the bright aspect in all animals. The shunts needed in average three irrigations with saline heparin solution to be kept unobstructed. The macroscopic and microscopic evaluation of the pulmonary tissue did not evidence fat emboli. Conclusion: The artery osseous or artery medullar (marrow) shunt showed to be feasible on the technical point of view in the laboratory.

Isquemia e reperfusão por circulação retrógrada: estudo comparativo experimental

“…[1][2][3][4][5][6][7][8][9][10][11][12][13] The concept is based on the theory that in the absence of primary arterial blood pressure in arterioles, blood supplied by arterialization of the distal venous system is capable of supplying the peripheral tissues and providing adequate oxygenation. [3][4][5]13 Many different variables have been used to evaluate tissue hypoxia in animal models, such as assessment of arterial flow using Doppler ultrasound (US), 14,15 temperature measurements, 16 blood gas analysis, 17 lactate 18 and creatine phosphokinase (CP) assays, 19 and measurements of arterial blood pressure at extremities. 20 The objective of this study is to compare the behavior of these clinical and laboratory variables in pigs' hind limbs after induction of ischemia, with and without reperfusion via retrograde circulation, against each other and in relation to a control group.…”