Morphometric Analysis of the Aorto-Esophageal Relationship in Swine for Trans-Esophageal Aortic Blood Flow Occlusion

Authors

  • Samuel G Savidge University of Maryland School of Medicine
  • Hossam Abdou R Adams Cowley Shock Trauma Center, University of Maryland Medical System
  • Joseph Edwards R Adams Cowley Shock Trauma Center, University of Maryland Medical System
  • Neerav Patel R Adams Cowley Shock Trauma Center, University of Maryland Medical System
  • Michael J Richmond R Adams Cowley Shock Trauma Center, University of Maryland Medical System
  • Rebecca Treffalls R Adams Cowley Shock Trauma Center, University of Maryland Medical System
  • Joseph Rabin R Adams Cowley Shock Trauma Center, University of Maryland Medical System
  • Jonathan J Morrison R Adams Cowley Shock Trauma Center, Baltimore

DOI:

https://doi.org/10.26676/jevtm.v5i3.219

Keywords:

Hemorrhage, Esophagus, Aorta, Swine, Anatomy, Transesophageal

Abstract

Background

Trans-esophageal aortic blood flow occlusion (TEABO) is an emerging technology undergoing laboratory research that offers a strategy for temporary hemorrhage control. The purpose of this study was to evaluate the anatomical relationship between the esophagus and descending thoracic aorta in two breeds of swine to support a porcine model for future TEABO investigations.

Methods

Thoracoabdominal CT scans were compared in Hanford miniature swine and Yorkshire swine. Measurements were taken at the five vertebral levels proximal to the gastroesophageal junction. Data collected included the distance between the center of the esophagus and the center of the descending aorta, the angle between the vertebral column, descending aorta, and esophagus, and the length the thoracic esophagus travels anteriorly to the descending aorta.

Results

Ten Hanford swine and ten Yorkshire swine were compared. In Hanford swine, the distal thoracic esophagus travels anteriorly to the descending aorta for a mean distance of 11.5 ± 2.3 cm. In Yorkshire swine, the thoracic esophagus travels to the right of the descending aorta. The mean angle between the vertebral body, descending aorta, and esophagus was 79.6 to 97.8 degrees higher in Hanfords compared to Yorkshires (p<0.0001 at all five vertebral levels compared). The mean distance between the esophagus and descending aorta was 0.2 to 0.6 cm higher in Hanfords compared to Yorkshires with a significant difference found at only two vertebral levels (p=0.01 and p=0.02).

Conclusion

Hanford miniature swine possess an aorto-esophageal relationship comparable to humans and should be the preferred animal model for TEABO studies.

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Published

2022-01-11

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Section

Original Article