AN EXPERIMENT WITHOUT CONTRAST IMPLANTATION OF STENTS INTO THE CAROTID ARTERY OF SHEEP UNDER THE CONTROL OF IVUS IN AN EXPERIMENT

Alexey Yu. Kolesnikov; Anastasia A. Arnt; Amin R. Shabaev; Yulia A. Kudryavtseva; Alyona A. Mikhailova; Nikita A. Kochergin

doi:10.17802/2306-1278-2025-14-6-194-200

AN EXPERIMENT WITHOUT CONTRAST IMPLANTATION OF STENTS INTO THE CAROTID ARTERY OF SHEEP UNDER THE CONTROL OF IVUS IN AN EXPERIMENT

Alexey Yu. Kolesnikov, Anastasia A. Arnt, Amin R. Shabaev, Yulia A. Kudryavtseva, Alyona A. Mikhailova, Nikita A. Kochergin

https://doi.org/10.17802/2306-1278-2025-14-6-194-200

Full Text:

PDF (Rus)

Generate QR code

Abstract

Highlights

Contrast‑induced nephropathy is a serious complication of endovascular procedures caused by the administration of contrast media; its incidence reaches 30 %, and no effective treatments for сontrast‑induced nephropathy currently exist.
The study proposes an innovative stenting technique using external and intravascular ultrasound guidance that completely eliminates the use of contrast media and fluoroscopy, thereby avoiding the risk of developing contrast‑induced nephropathy.
The use of intravascular ultrasound as a substitute for conventional angiography has the potential to reduce or completely eliminate the need for fluoroscopy and contrast media during stenting; this technique has demonstrated safety and efficacy, but requires further clinical research.

Aim. To develop a technique for contrast-free and fluoroscopic stenting in an experiment using intravascular ultrasound.

Methods. In the experiment, six healthy sheep of the Edilbaev’s breed, under general anesthesia and under the control of percutaneous ultrasound, underwent puncture of the common carotid artery. After systemic heparinization (2 500 units), a IVUS sensor was installed to assess the reference diameter of the vessel and select the required stent size. In parallel to the sensor, the stent is placed 0.5–1.0 cm distally. After positioning, the IVUS sensor was inserted into a conductive catheter for further monitoring. The stent was implanted with a nominal pressure (9–10 atm), after which the IVUS was monitored, and when a malformation was detected, postdilation with a balloon from under the stent (14–16 atm.) was performed with a re-evaluation of the result. Coronary balloon-expandable stents were implanted in sheep, sizes 5 × 8 mm and 4.5 × 10 mm were used.

Results. Suturing of the puncture site was performed using an Angio-seal device. In the postoperative period, all animals were prescribed double antiplatelet therapy. On a control ultrasound 3 months after stenting, the stents are passable.

Conclusion. The problem of reducing the fluoroscopy time and the amount of contrast used remains one of the most urgent today. The use of IVUS, as a replacement for the usual angiography, can potentially lead to a decrease or even complete absence of X-ray and CA during stenting. The technique demonstrated above has shown its safety and viability. However, this methodology requires further clinical studies.