Development of a Novel Recurrent Gastrointestinal Bleeding Model in Swine for Provocative Mesenteric Angiography

Abstract

Purpose The purpose of this study was to develop a novel swine model of recurrent gastrointestinal bleeding that could potentially be utilized for the study of provocative mesenteric angiography.

Methods Animal experiments were approved by the Institutional Animal Care and Use Committee. The superior mesenteric artery was catheterized via percutaneous transfemoral access. Via laparotomy, multiple small incisions were created in the small bowel wall of four swine. After hemostasis was achieved, varying amounts of thrombolytics were infused into the superior mesenteric artery via a 5 french catheter. The number of incisions with observable rebleeding and interval until rebleeding were ascertained.

Results In a test animal, active extravasation was confirmed to be detectable on digital subtraction angiography at a small bowel incision site. After tissue plasminogen activator (tPA) administration into the superior mesenteric artery, rebleeding from the incisions was visually observed in 11 of 30 small bowel incisions (37%). Provoked bleeding occurred at a median of 6 minutes (mean: 5 minutes and 52 seconds) after completion of tPA injection with a range of approximately 1 to 10 minutes.

Conclusion This pilot study proposes a feasible model for provocative mesenteric angiography in swine.

Keywords

gastrointestinal bleeding - angiography - provocative mesenteric angiography

Publication History

Received: 10 November 2020

Accepted: 09 March 2021

Article published online:
04 May 2021

• References

• 1 Kim CY. Provocative mesenteric angiography for diagnosis and treatment of occult gastrointestinal hemorrhage. Gastrointest Interv 2018; 7 (03) 150-154
• 2 Widlus DM, Salis AI. Reteplase provocative visceral arteriography. J Clin Gastroenterol 2007; 41 (09) 830-833
• 3 Ryan JM, Key SM, Dumbleton SA, Smith TP. Nonlocalized lower gastrointestinal bleeding: provocative bleeding studies with intraarterial tPA, heparin, and tolazoline. J Vasc Interv Radiol 2001; 12 (11) 1273-1277
• 4 Bloomfeld RS, Smith TP, Schneider AM, Rockey DC. Provocative angiography in patients with gastrointestinal hemorrhage of obscure origin. Am J Gastroenterol 2000; 95 (10) 2807-2812
• 5 Kim CY, Suhocki PV, Miller Jr MJ, Khan M, Janus G, Smith TP. Provocative mesenteric angiography for lower gastrointestinal hemorrhage: results from a single-institution study. J Vasc Interv Radiol 2010; 21 (04) 477-483
• 6 Camus M, Marteau P, Pocard M. et al. Validation of a live animal model for training in endoscopic hemostasis of upper gastrointestinal bleeding ulcers. Endoscopy 2013; 45 (06) 451-457
• 7 Chen VK, Marks JM, Wong RC. et al. Creation of an effective and reproducible nonsurvival porcine model that simulates actively bleeding peptic ulcers. Gastrointest Endosc 2008; 68 (03) 548-553
• 8 Hu B, Chung SC, Sun LC. et al. Developing an animal model of massive ulcer bleeding for assessing endoscopic hemostatic devices. Endoscopy 2005; 37 (09) 847-851
• 9 Roussi J, André P, Samama M. et al. Platelet functions and haemostasis parameters in pigs: absence of side effects of a procedure of general anaesthesia. Thromb Res 1996; 81 (03) 297-305
• 10 Bowie EJ, Owen Jr CA, Zollman PE, Thompson Jr JH, Fass DN. Tests of hemostasis in swine: normal values and values in pigs affected with von Willebrand's disease. Am J Vet Res 1973; 34 (11) 1405-1407
• 11 Gross DR. Thromboembolic phenomena and the use of the pig as an appropriate animal model for research on cardiovascular devices. Int J Artif Organs 1997; 20 (04) 195-203
• 12 Byrom MJ, Bannon PG, White GH, Ng MK. Animal models for the assessment of novel vascular conduits. J Vasc Surg 2010; 52 (01) 176-195