RESUMO
Microvascular obstruction (MVO) often occurs in ST-elevation myocardial infarction (STEMI) patients after percutaneous coronary intervention (PCI). Diagnosis and treatment of MVO lack appropriate and established procedures. This study focused on two major points by using an in vitro multiscale flow model, which comprised an aortic root model with physiological blood flow and a microfluidic model of the microcirculation with vessel diameters down to 50 µm. First, the influence of porcine microthrombi (MT), injected into the fluidic microchip, on perfusion was investigated. We found that only 43% of all injected MT were fully occlusive. Second, it could also be shown that the maximal concentration of a dye (representing therapeutic agent) during intracoronary infusion could be increased on average by 58%, when proximally occluding the coronary artery by a balloon during drug infusion. The obtained results and insights enhance the understanding of perfusion in MVO-affected microcirculation and could lead to improved treatment methods for MVO patients.
RESUMO
Microvascular Obstruction (MVO) is a common consequence of acute myocardial infarction. MVO is underdiagnosed and treatment is often nonspecific and ineffective. A multi-scale in-vitro benchtop model was established to investigate drug perfusion in MVO affected microcirculation. The central element of the benchtop model was a fluidic microchip containing channels with diameters between [Formula: see text] and 50 µm representing [Formula: see text] of the microvascular tree fed by the left anterior descending artery (LAD). The outlets of the chip could be closed to mimic MVO. Two methods for intracoronary infusion of pharmacologic agents (simulated by dye) to regions with MVO were investigated using an occlusion-infusion catheter. The first case was a simple, bolus-like infusion into the LAD, whereas the second case consisted of infusion with concomitant proximal occlusion of the LAD phantom with a balloon. Results show that local dye concentration maxima in the chip with MVO were 2.2-3.2 times higher for the case with proximal balloon occlusion than for the conventional infusion method. The cumulated dose could be raised by a factor 4.6-5.2. These results suggest that drug infusion by catheter is more effective if the blood supply to the treated vascular bed is temporarily blocked by a balloon catheter.
Assuntos
Infarto do Miocárdio , Intervenção Coronária Percutânea , Humanos , Intervenção Coronária Percutânea/métodos , Vasos Coronários , Coração , Catéteres , Microcirculação , Circulação CoronáriaRESUMO
Large-format natural corks were individually screened for trichloroanisole (TCA) taint and other non-characteristic cork odors by smelling the high relative humidity headspace of the jarred closure during expert panel sensory sessions. The method was coined "dry soak sensory screening". Out of a population of 2296 corks, 138 specimens [6% of the total population (TP)] were retained because of unusual odors, ranging from mild to severe. All retained corks were analyzed for releasable TCA (RTCA) by the solid-phase microextraction (SPME) gas chromatography/mass spectrometry (GC/MS) technique. Results indicated that 30 corks (1.3% TP) had concentrations between 1.0 and 5.0 ppt. Most of these corks had non-typical TCA odors described as ashtray, musty, moldy, dirty, and wet cardboard. A total of 13 retained corks (0.57% TP) had RTCA values higher than 5.0 ppt, mostly displaying the typical TCA odor. Dry soak screening has been determined to be a clean, fast, and most importantly, a nondestructive method ideal for screening large-format natural corks with off odors.
