E-ISSN: 1305-3612
    Balloon occlusion of the right main bronchus in an ovine model provides sufficient time for emergent interventions in massive pulmonary embolism
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    Interventional Radiology - Original Article
    VOLUME: 18 ISSUE: 1
    P: 127-131
    January 2012

    Balloon occlusion of the right main bronchus in an ovine model provides sufficient time for emergent interventions in massive pulmonary embolism

    Diagn Interv Radiol 2012;18(1):127-131
    DOI: 10.4261/1305-3825.DIR.4069-10.2
    Yong Fan 1
    Yang Liu 2
    Rahmi Oklu 3
    Neng-Shu He 4
    Ping Li 5
    Qi Wu 6
    Amy Deipolyi 7
    Stephan Wicky 8
    Ho-Young Song 9
    1. Graduate School Tianjin Medical University, Tianjin, China
    2. Department of Radiology, Children's Hospital, Tianjin, China
    3. Division of Vascular Imaging and Intervention, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
    4. Department of Radiology, Tianjin Medical University General Hospital, Tianjin, China
    5. Departments of Radiology, Haihe Hospital, Tianjin, China
    6. Departments of Pulmonology, Haihe Hospital, Tianjin, China
    7. Department of Vascular Imaging and Interventions, Harvard University Medical School, Massachusetts General Hospital, Massachusetts, USA
    8. Department of Vascular Imaging and Interventions Harvard Medical School, Massachusetts General Hospital, Boston, Massachusetts, USA
    9. Department of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
    No information available.
    No information available
    Received Date: 12.04.2011
    Accepted Date: 31.05.2011
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    ABSTRACT

    PURPOSE

    Massive pulmonary embolism (PE) causes hemodynamic compromise and is associated with a high rate of mortality. We sought to create a model of massive PE and to determine whether occlusion of the right main bronchus could mitigate the physiological effects of massive PE in this model.

    MATERIALS AND METHODS

    We used 27 female sheep to generate a model of massive PE by either autologous blood clot injection (n=18) or detachable balloon release (n=9) into the right main pulmonary artery. Four sheep were excluded after blood clot injection, as they did not exhibit adequate declines in blood oxygen saturation (SaO2). Nine of the sheep that received autologous blood clot and nine that received detachable balloons went on to treatment with right main bronchus occlusion. The control group (n=5) received the autologous blood clot, but no occlusion of the right main bronchus. All sheep underwent continuous monitoring of pulmonary arterial mean pressure (PAMP), SaO2, arterial partial pressure of oxygen (PaO2), and arterial partial pressure of carbon dioxide.

    RESULTS

    Twenty-three sheep (85%) subjected to PE demonstrated immediate tachycardia, tachypnea, and decline in SaO2 of at least 25% within 30 min. After right main bronchus occlusion, 18 sheep (100%) survived for the length of the experiment and exhibited persistently higher SaO2 and PaO2 levels, as well as decreased PAMP compared with the controls. In the control group, two out of five sheep died within 30 min, and the three surviving subjects demonstrated significantly decreased SaO2 and PaO2 levels.

    CONCLUSION

    Occlusion of the right main bronchus in an ovine model of massive PE effectively extends life and provides favorable physiological parameters to allow emergent interventions.

    Keywords: pulmonary embolism, ventilation-perfusion ratio, balloon catheterization, animal experimentation

    References

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