我们要感谢安吉拉·弗伦德夫人在嵌入和幻灯片生产方面提供的宝贵技术援助。我们还要感谢实验室动物科学和实验外科研究所的塔杜斯·斯托平斯基先生在兽医工作中的有见地的帮助。

这些实验是根据德国动物福利法（TSchG）和2010/63/欧盟关于保护用于科学目的的动物的指令进行的。政府动物护理和使用委员会批准了这项研究的正式批准（第87-51.04.A065号议定书：兰德萨姆特·法尔·纳图尔，乌姆韦尔特·德·弗布劳彻舒茨·诺德海因-韦斯特法伦，德国雷克林豪森）。研究协议符合《实验室动物护理和使用指南》。术后疼痛治疗基于德国实验室动物科学协会 （GV-SOLAS） 的建议以及主动兽医疼痛治疗。
1. 基本技术和常见程序
<ol><li>使用同源猿-/- 斯普拉格-道利大鼠。使用标准方法17识别每种动物的基因型。</li>
	<li>将动物保持在相同的条件下（21 °C ± 2 °C，60%± 5% 的湿度，以及 12 小时的光/暗循环），并确保免费获得水和食物。</li>
	<li>在清洁但非星号条件下执行所有程序。</li>
	<li>一旦大鼠麻醉，在手术显微镜下执行所有手术，倍数为16倍。</li>
	<li>使用棉签进行压缩溶血。用乳化铃声溶液浸泡的纱布（5 厘米 x 5 厘米）有助于保持腹股沟湿润。</li>
	<li>遵守废物处理条例，处理废旧材料。</li>
</ol>2. 手术前的准备
<ol><li>在开始操作之前准备兽药。除非另有说明，否则请在室温下保留所有解决方案。</li>
	<li>
手术前30分钟，皮下施用 0.03-0.05毫克/千克丁丙诺啡。
</li>
	<li>麻醉大鼠，注射100毫克/千克体重（BW）和8毫克/千克BW西拉辛。</li>
	<li>使用称重秤评估大鼠的体重。</li>
	<li>将鼠放在加热垫上，用医用胶带固定上下肢。将大鼠的左后肢完全伸展，并尽可能与脊椎保持一致，从而在股动脉和主动脉之间形成一条直线。这将促进气球安装支架通过主动脉分叉前进。</li>
	<li>保持麻醉，吸入1.5伏的异氟烷在97.5%的氧气中，流量为2L/min。 注意：允许大鼠自发呼吸，无需管网。</li>
	<li>应用眼药膏，防止无意识时眼睛损伤。</li>
	<li>从大鼠腹股沟和下腹部区域剃毛，用波维酮碘溶液对相应的皮肤进行消毒。</li>
	<li>在开始手术之前，通过捏紧尾尖和分形组织来验证麻醉的深度。</li>
</ol>3. 手术
<ol><li>在左腹股沟中切开约 0.5+u20121 厘米，以打开皮肤和底层筋膜。</li>
	<li>在深部进行模糊解剖和探查，直到可以识别脉动的左股动脉。</li>
	<li>使用非常精细的钳子，通过轻轻取出周围的结缔组织来准备股骨动脉。小心伤害股骨神经和股骨静脉，这是动脉中间。</li>
	<li>准备大约1厘米的股骨动脉。小心地将钳尖放在容器下，轻轻抬起。</li>
	<li>线条4-0丝缝合线下动脉的解剖和接近部分，并形成吊索。夹住手术夹的分支之间的两根螺纹吊索的末端。使用手术夹控制动脉。轻轻伸展和抬起吊索，以暂时中断血液流动。 注意：快速工作，以避免可能导致组织损伤的长时间旅游。</li>
	<li>使用锋利的微剪刀，在股动脉中间进行动脉切除术。</li>
	<li>通过动脉切除术引入导线。当到达近线吊索时，通过移动手术夹释放螺纹的张力，并将导线进一步向腹部主动脉推进。 注意：使用切割机切割导线以便于操作。</li>
	<li>将导线的近端放置在隔膜和肾动脉之间。 注意：将导线推进太远会承受主动脉或心脏损伤的风险。我们建议打开腹部，以确保引导线和支架的充分定位，至少对于前几只动物。</li>
	<li>在导引线上引入一个压接式和气球式冠状动脉支架，尺寸为 2.25 mm x 8 mm（最大 2.5 mm x 8 mm），并将其推进到腹动脉。</li>
	<li>将支架放在主动脉分叉上方，但放在肾动脉下方。使用充气注射器系统将气球导管充气至 12 atm 15s，从而部署支架。</li>
	<li>根据制造商对使用支架的建议，放气气球导管并保持负压。</li>
	<li>在将支架留在原位时，慢慢取出放气导管。</li>
	<li>在取出导管之前，用手术夹在切口上方的螺纹环上制造张力，再次中断血液流动。然后取出气球导管，直接将容器靠近。</li>
	<li>将近部和解剖线环系成石灰，以盖住股动脉，并确认动脉切除术的充分血吸虫。辅助动脉将确保进一步灌注到肢体。</li>
	<li>使用 10-0 非可恢复缝合，关闭动脉的肌肉以及皮肤切口。</li>
</ol>4. 支架植入后的动物护理
<ol><li>手术后，让老鼠在特殊的重症监护室笼子里恢复60分钟，笼子里有温暖的空气（30\u201235°C）和氧气供应。</li>
	<li>仔细观察动物，直到完全康复。之后，将老鼠移入普通笼子。提供获得水和食物的辅助通道。</li>
	<li>根据临床评估，每6-12小时服用一次术后镇痛，服用0.03-0.05毫克/千克丁丙诺啡（s.c.，500μl NaCl），共72小时。</li>
	<li>将食物与氯皮多格雷（15毫克/千克）混合，以避免植入支架的血栓形成。</li>
	<li>为了改善高血糖条件和斑块形成，在出生后6\u20128周开始西方饮食喂养，一直持续到安乐死。如果需要，一群喂养正常老鼠的动物可以作为控制。</li>
</ol>5. 组织收集和处理
<ol><li>在指定时间点开始组织去除之前，根据 IACUC 指南对动物实施安乐死。在观察期结束时收获被强化的主动脉进行病理分析。</li>
	<li>通过中线切口打开腹部，取出主动脉的固定部分以及主动脉的相邻非固定部分，每个部分尺寸为 0.5 厘米。</li>
	<li>将组织放入 4% 缓冲形式素的溶液中，以进行 24 小时的固定。</li>
	<li>将被强化的动脉组织嵌入塑料中，并按照标准协议18、19进行组织学和免疫化学染色。</li>
</ol>6. 组织学分析
<ol><li>通过与计算机相连的显微镜，使用适当的图像分析软件，对紧固主动脉的近、中、离部分的顺序部分进行成形分析。</li>
	<li>使用图形绘图板跟踪外部弹性拉米纳（EEL，在冒险和介质之间）、内部弹性拉米纳（IEL、介质和新因蒂玛之间）和流明的轮廓。从这些值中，使用软件计算 EEL 区域、IEL 区域和流明区域。</li>
	<li>计算支架内复发 （ISR） 的横截面面积百分比： <img alt="Equation 1" src="/files/ftp_upload/61442/61442equ01.jpg">
</li>
	<li>计算新近面积（Ai）： <img alt="Equation 2" src="/files/ftp_upload/61442/61442equ02.jpg">
</li>
	<li>测量每个支架支柱上的新意厚度 （NIT），作为支柱和流明之间的距离。测量支架支柱之间的NIT，作为 IEL 和流明之间的距离。 注：或者，将NIT计算为 <img alt="Equation 3" src="/files/ftp_upload/61442/61442equ03.jpg"> 其中PL和PIEL是流明和内部弹性拉米纳周长，分别为20。</li>
	<li>根据研究的要求进行额外的分析。</li>
</ol>

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J., de Vries, J. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Flow+diverter+implantation+in+a+rat+model+of+sidewall+aneurysm:+a+feasibility+study.">Flow diverter implantation in a rat model of sidewall aneurysm: a feasibility study.</a> Journal of NeuroInterventional Surgery. 10 (1), 88-92 (2018).</li></ol>

作者没有什么可透露的。

本协议描述了将人类大小的冠状动脉支架植入大鼠腹 主动脉。几个技术点值得强调。首先，应避免支架大小和主动脉大小之间的不匹配。放置过小的支架会导致支架失调，而植入对主动脉来说太大的支架则会导致血管过度拉伸、撕裂和损伤。因此，我们建议使用直径在 2.0 到 2.5 毫米之间的支架，并将植入压力保持在建议范围内，而不要过度拉伸支架。最合适的植入压力通常由支架制造商...

皮下冠心病干预（PCI），结合冠状支架的部署，代表了冠状动脉疾病干预治疗的黄金标准1。然而，支架的长期成功可以限制在支架内复发（ISR）的发生，这是由支架2，3内新意组织过度增殖决定的。ISR 可能需要用冠状动脉旁路或重新 PCI 进行重新干预。为研究ISR提出了各种动物模型的建议，每个模型都有优点和缺点。最常用的猪冠状动脉和兔肠动脉模型的主要缺点，虽然在支架植入4、5后出现与人类明显相似的病变，但动物和住房成本高，这带来了后勤困难，特别是在长期研究中，以及处理和设备的限制。此外，猪和兔子细胞蛋白抗体的可用性有限。另一方面，Murine 模型具有吞吐量高、可重复性高、易于操作、外壳等主要优点，因此具有成本效益。此外，有较多的抗体可用。然而，虽然非丙蛋白电子缺乏症（apoE-/-）小鼠已被广泛用于动脉粥样硬化6，7，8的研究，他们不适合研究ISR，因为支架必须小型化植入小鼠，有可能改变支架的机械特性。此外，小鼠主动脉壁测量在幼鼠50μm和老老鼠9中85μm之间，支架必须使用低至2 atm的压力水平进行部署，这可能导致支架10的不良位。然而，大鼠允许植入市售的人类冠状动脉支架，并表现出类似于主动脉支架植入后较大的动物的血管愈合过程，首先由Langeveld等人11日报道。这项技术最初需要跨腹部通道，这就需要对主动脉进行物理收缩，以实现血液流动的暂时中断。为了避免潜在的相关船只伤害和炎症反应，该技术后来通过引入一个跨组织访问，这进一步导致动物12的存活率更高。
由于野生类型大鼠不发展动脉粥样硬化病变13，apoE-/-大鼠已产生使用核酶技术，如转录激活器一样的影响器核糖核酸（TALEN）14，聚类定期间歇短巴林德罗米重复（CRISPR/Cas9）15，和锌手指（ZF）16。自 2011 年以来，ApoE-/-大鼠已上市。提供外来背景，apoE-/-大鼠允许更现实地评估人类大小的冠状动脉支架，特别是关于ISR。
在此，我们通过跨性别访问路线描述该方法，并使用市售的薄支柱钴-铬药物脱脂支架 （DES），但是，它也可用于研究其他支架类型，如裸金属支架 （BMS） 或可生物降解支架。

<table>
	<tbody>
		<tr>
			<td>Diet</td>
			<td></td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>SNIFF High Fat diet + Clopidogrel (15 mg/kg)</td>
			<td>SNIFF Spezialdi&#228;ten GmbH, Soest</td>
			<td>custom prepared</td>
			<td>Western Diet</td>
		</tr>
		<tr>
			<td></td>
			<td></td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>Drugs and Anesthetics</td>
			<td></td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>Buprenorphine</td>
			<td>Essex Pharma</td>
			<td>997.00.00</td>
			<td></td>
		</tr>
		<tr>
			<td>ISOFLO (Isoflurane Vapor) vaporiser</td>
			<td>Eickemeyer</td>
			<td>4802885</td>
			<td></td>
		</tr>
		<tr>
			<td>Isoflurane</td>
			<td>Forene Abbott</td>
			<td>B 506</td>
			<td></td>
		</tr>
		<tr>
			<td>Isotonic (0.9%) NaCl solution</td>
			<td>DeltaSelect GmbH</td>
			<td>PZN 00765145</td>
			<td></td>
		</tr>
		<tr>
			<td>Ringer&#39;s lactate solution</td>
			<td>Baxter Deutschland GmbH</td>
			<td>3775380</td>
			<td></td>
		</tr>
		<tr>
			<td>(S)-ketamine</td>
			<td>CEVA Germany</td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>Xylazine</td>
			<td>Medistar Germany</td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td></td>
			<td></td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>Consumable supplies</td>
			<td></td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>10 mL syringes</td>
			<td>BD Plastipak</td>
			<td>4606108V</td>
			<td></td>
		</tr>
		<tr>
			<td>2 mL syringes</td>
			<td>BD Plastipak</td>
			<td>4606027V</td>
			<td></td>
		</tr>
		<tr>
			<td>6-0 prolene suture</td>
			<td>ETHICON</td>
			<td>N-2719K</td>
			<td></td>
		</tr>
		<tr>
			<td>4-0 silk suture</td>
			<td>Seraflex</td>
			<td>IC 158000</td>
			<td></td>
		</tr>
		<tr>
			<td>Bepanthen Eye and Nose Ointment</td>
			<td>Bayer Vital GmbH</td>
			<td>6029009.00.00</td>
			<td></td>
		</tr>
		<tr>
			<td>Cotton Gauze swabs</td>
			<td>Fuhrmann GmbH</td>
			<td>32014</td>
			<td></td>
		</tr>
		<tr>
			<td>Durapore silk tape</td>
			<td>3M</td>
			<td>1538-1</td>
			<td></td>
		</tr>
		<tr>
			<td>Poly-Alcohol Skin Desinfection Solution</td>
			<td>Antiseptica GmbH</td>
			<td>72PAH200</td>
			<td></td>
		</tr>
		<tr>
			<td>Sterican needle 18 G</td>
			<td>B. Braun</td>
			<td>304622</td>
			<td></td>
		</tr>
		<tr>
			<td>Sterican needle 27 3/4 G</td>
			<td>B.Braun</td>
			<td>4657705</td>
			<td></td>
		</tr>
		<tr>
			<td>Tissue Paper</td>
			<td>commercially available</td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td></td>
			<td></td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>Surgical instruments</td>
			<td></td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>Graefe forceps curved x1</td>
			<td>Fine Science Tools Inc.</td>
			<td>11151-10</td>
			<td></td>
		</tr>
		<tr>
			<td>Graefe forceps straight</td>
			<td>Fine Science Tools Inc.</td>
			<td>11050-10</td>
			<td></td>
		</tr>
		<tr>
			<td>Needle holder Mathieu</td>
			<td>Fine Science Tools Inc.</td>
			<td>12010-14</td>
			<td></td>
		</tr>
		<tr>
			<td>Scissors</td>
			<td>Fine Science Tools Inc.</td>
			<td>14074-11</td>
			<td></td>
		</tr>
		<tr>
			<td>Semken forceps</td>
			<td>Fine Science Tools Inc.</td>
			<td>11008-13</td>
			<td></td>
		</tr>
		<tr>
			<td>Small surgical scissors curved</td>
			<td>Fine Science Tools Inc.</td>
			<td>14029-10</td>
			<td></td>
		</tr>
		<tr>
			<td>Small surgical scissors straight</td>
			<td>Fine Science Tools Inc.</td>
			<td>14028-10</td>
			<td></td>
		</tr>
		<tr>
			<td>Standard pattern forceps</td>
			<td>Fine Science Tools Inc.</td>
			<td>11000-12</td>
			<td></td>
		</tr>
		<tr>
			<td>Vannas spring scissors</td>
			<td>Fine Science Tools Inc.</td>
			<td>15000-08</td>
			<td></td>
		</tr>
		<tr>
			<td></td>
			<td></td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>Equipment</td>
			<td></td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>Dissecting microscope</td>
			<td>Leica MZ9</td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>Temperature controlled heating pad</td>
			<td>Sygonix</td>
			<td>26857617</td>
			<td></td>
		</tr>
		<tr>
			<td></td>
			<td></td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>Equipment for stent implantation</td>
			<td></td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>Drug-eluting stent Xience 2,25mm x 8mm</td>
			<td>Abbott Vascular USA</td>
			<td>1009544-18</td>
			<td></td>
		</tr>
		<tr>
			<td>Guide wire Fielder XT PTCA guide wire: 0.014&#34; x 300cm</td>
			<td>ASAHI INTECC CO., LTD Japan</td>
			<td>AGP140302</td>
			<td></td>
		</tr>
		<tr>
			<td>Inflation syringe system</td>
			<td>Abbott 20/30 Priority Pack</td>
			<td>1000186</td>
			<td></td>
		</tr>
		<tr>
			<td></td>
			<td></td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>Tissue processing and analysis</td>
			<td></td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>30% H2O2</td>
			<td>Roth</td>
			<td>9681</td>
			<td>Histology</td>
		</tr>
		<tr>
			<td>Ethanol</td>
			<td>Roth</td>
			<td>K928.1</td>
			<td>Histology</td>
		</tr>
		<tr>
			<td>Giemsas Azur-Eosin-Methylenblau</td>
			<td>Merck</td>
			<td>109204</td>
			<td>Histology</td>
		</tr>
		<tr>
			<td>Graphic Drawing Tablet</td>
			<td>WACOM Europe GmbH</td>
			<td>CTL-6100WLK-S</td>
			<td></td>
		</tr>
		<tr>
			<td>Roti Histofix, Formaldehyd 4% buffered</td>
			<td>Roth</td>
			<td>P087</td>
			<td>Histology</td>
		</tr>
		<tr>
			<td>Technovit 9100</td>
			<td>Morphisto</td>
			<td>12225.K1000</td>
			<td>Histology</td>
		</tr>
	</tbody>
</table>

implantation of human-sized coronary stents into rat abdominal aorta using a trans-femoral access

皮下冠心病干预 （PCI） 结合冠状支架的部署，代表了冠状动脉疾病干预治疗的黄金标准。支架内恢复症 （ISR） 是由支架内新辛蒂莫组织过度增殖决定的，并限制支架的长期成功。各种动物模型被用来阐明支架内复发 （ISR） 背后的病理生理过程，其中猪冠状动脉和兔子胆道模型最常使用。Murine 模型具有吞吐量高、易于处理和外壳、可重复性和分子标记的广泛可用性等优点。非丙蛋白E缺乏（apoE-/-）小鼠模型已广泛用于研究心血管疾病。然而，支架必须小型化才能植入小鼠体内，这涉及到其机械和（潜在）生物特性的重大变化。使用猿类-/-大鼠可以克服这些缺点，因为apoE-/-大鼠允许评估人类大小的冠状动脉支架，同时提供一个异位表型。这使得它们成为在支架植入后研究 ISR 的极好可靠的模型。在这里，我们详细描述了将市售的人类冠状动脉支架植入具有apoE-/-背景的老鼠的腹部主动脉，使用跨股骨访问。

该协议描述了使用跨股骨通道（图1）植入大鼠腹部主动脉的支架。这种动物模型的第一个中心点是，它允许部署人类大小的冠状动脉支架。一个市售的压接和气球安装冠状动脉支架可以放置到大鼠的腹部主动脉。因此，还可以应用与人类相同的支架部署原则。使用大鼠的另一个优点是提供转基因菌株，如apoE-/- 大鼠，这些菌株在商业上是可用的。
<p class="jove_conten...

Watch this Scientific Journal Video about Implantation of Human-Sized Coronary Stents into Rat Abdominal Aorta Using a Trans-Femoral Access at JoVE.com

Implantation of Human-Sized Coronary Stents into Rat Abdominal Aorta Using a Trans-Femoral Access

该协议描述了人类冠状动脉支架植入大鼠的腹部主动脉与apoE-/- 背景使用跨股骨访问。与其他动物模型相比，穆林模型具有吞吐量高、可重复性高、易处理性和外壳性好等优点，分子标记物广泛可用。

使用跨女性访问将人类大小的冠状动脉支架植入大鼠腹主动脉

Percutaneous coronary intervention (PCI), combined with the deployment of a coronary stent, represents the gold standard in interventional treatment of ...

implantation-human-sized-coronary-stents-into-rat-abdominal-aorta

Research

JoVE Journal

Medicine

4.1K 次观看.  University Hospital RWTH Aachen. 该协议描述了人类冠状动脉支架植入大鼠的腹部主动脉与apoE-/- 背景使用跨股骨访问。与其他动物模型相比，穆林模型具有吞吐量高、可重复性高、易处理性和外壳性好等优点，分子标记物广泛可用。

视频: Implantation of Human-Sized Coronary Stents into Rat Abdominal Aorta Using a Trans-Femoral Access

The C-seal: A Biofragmentable Drain Protecting the Stapled Colorectal Anastomosis from Leakage

Colorectal anastomotic leakage (AL) is a serious complication in colorectal surgery leading to high morbidity and mortality rates1. The incidence of AL varies between 2.5 and 20% 2-5. Over the years, many strategies aimed at lowering the incidence of anastomotic leakage have been examined6, 7. 
The cause of AL is probably multifactorial. Etiological factors include insufficient arterial blood supply, tension on the anastomosis, hematoma and/or infection at the anastomotic site, and co-morbid factors of the patient as diabetes and atherosclerosis8. Furthermore, some anastomoses may be insufficient from the start due to technical failure.
Currently a new device is developed in our institute aimed at protecting the colorectal anastomosis and lowering the incidence of AL. This so called C-seal is a biofragmentable drain, which is stapled to the anastomosis with the circular stapler. It covers the luminal side of the colorectal anastomosis thereby preventing leakage.
The C-seal is a thin-walled tube-like drain, with an approximate diameter of 4 cm and an approximate length of 25 cm (figure 1). It is a tubular device composed of biodegradable polyurethane. Two flaps with adhesive tape are found at one end of the tube. These flaps are used to attach the C-seal to the anvil of the circular stapler, so that after the anastomosis is made the C-seal can be pulled through the anus. The C-seal remains in situ for at least 10 days. Thereafter it will lose strength and will degrade to be secreted from the body together with the gastrointestinal natural contents.
The C-seal does not prevent the formation of dehiscences. However, it prevents extravasation of faeces into the peritoneal cavity. This means that a gap at the anastomotic site does not lead to leakage.
Currently, a phase II study testing the C-seal in 35 patients undergoing (colo-)rectal resection with stapled anastomosis is recruiting. The C-seal can be used in both open procedures as well as laparoscopic procedures. The C-seal is only applied in stapled anastomoses within 15cm from the anal verge. In the video, application of the C-seal is shown in an open extended sigmoid resection in a patient suffering from diverticular disease with a stenotic colon.

The C-seal is a biofragmentable drain protecting the stapled colorectal anastomosis. In this video, details of the manufacturing, deployment and use are shown.

C密封：一个Biofragmentable漏漏电保护吻合结直肠吻合

Colorectal anastomotic leakage (AL) is a serious complication in colorectal surgery leading to high morbidity and mortality rates1. The incidence of AL ...

科研

医学

Rat Heterotopic Abdominal Heart/Single-lung Transplantation in a Volume-loaded Configuration

Herein, we describe a novel technique for heterotopic abdominal heart-lung transplantation (HAHLT) in rats. The configuration of the transplant graft involves anastomosis of donor inferior vena cava (IVC) to recipient IVC, and donor ascending aorta (Ao) to recipient abdominal Ao. The right upper and middle lung lobes are preserved and function as conduits for blood flow from right heart to left heart.
There are several advantages to using this technique, and it lends itself to a broad range of applications. Because the graft is transplanted in a configuration that allows for dyamic volume-loading, cardiac function may be directly assessed in vivo. The use of pressure-volume conductance catheters permits characterization of load-dependent and load-independent hemodynamic parameters. The graft may be converted to a loaded configuration by applying a clamp to the recipient&#8217;s infra-hepatic IVC. We describe modified surgical techniques for both donor and recipient operations, and an ideal myocardial protection strategy. Depending on the experimental aim, this model may be adapted for use in both acute and chronic studies of graft function, immunologic status, and variable ventricular loading conditions. The conducting airways to the transplanted lung are preserved, and allow for acute lung re-ventilation. This facilitates analysis of the effects of the mixed venous and arterial blood providing coronary perfusion to the graft.
A limitation of this model is its technical complexity. There is a significant learning curve for new operators, who should ideally be mentored in the technique. A surgical training background is advantageous for those wishing to apply this model. Despite its complexity, we aim to present the model in a clear and easily applicable format. Because of the physiologic similarity of this model to orthotopic transplantation, and its broad range of study applications, the effort invested in learning the technique is likely to be worthwhile.

We describe a novel technique for heterotopic abdominal heart-lung transplantation (HAHLT) in rats. The transplant configuration results in a partially loaded graft circulation, allowing direct functional assessment. This model may be employed for acute or chronic studies of function and immunologic status of the transplanted graft.

大鼠异位心脏腹部/在卷装配置单肺移植

Herein, we describe a novel technique for heterotopic abdominal heart-lung transplantation (HAHLT) in rats. The configuration of the transplant graft ...

Creation of Abdominal Adhesions in Mice

Abdominal adhesions consist of fibrotic tissue that forms in the peritoneal space in response to an inflammatory insult, typically surgery or intraabdominal infection. The precise mechanisms underlying adhesion formation are poorly understood. Many compounds and physical barriers have been tested for their ability to prevent adhesions after surgery with varying levels of success. The mouse and rat are important models for the study of abdominal adhesions. Several different techniques for the creation of adhesions in the mouse and rat exist in the literature. Here we describe a protocol utilizing abrasion of the cecum with sandpaper and sutures placed in the right abdominal sidewall. The mouse is anesthetized and the abdomen is prepped. A midline laparotomy is created and the cecum is identified. Sandpaper is used to gently abrade the surface of the cecum. Next, several figure-of-eight sutures are placed into the peritoneum of the right abdominal sidewall. The abdominal cavity is irrigated, a small amount of starch is applied, and the incision is closed. We have found that this technique produces the most consistent adhesions with the lowest mortality rate.

Abdominal adhesions that form after surgery are a major cause of pain, infertility, and hospitalization and reoperation for small bowel obstruction. Our surgical procedure for creating abdominal adhesions in mice is a reliable tool to study the mechanisms underlying the formation of adhesions.

小鼠腹腔粘连的创建

Abdominal adhesions consist of fibrotic tissue that forms in the peritoneal space in response to an inflammatory insult, typically surgery or ...

A Model of Cardiac Remodeling Through Constriction of the Abdominal Aorta in Rats

Heart failure is one of the leading causes of death worldwide. It is a complex clinical syndromethat includes fatigue, dyspnea, exercise intolerance, and fluid retention. Changes in myocardial structure, electrical conduction, and energy metabolism develop with heart failure, leading to contractile dysfunction, increased risk of arrhythmias, and sudden death. Hypertensive heart disease is one of the key contributing factors of cardiac remodeling associated with heart failure. The most commonly-used animal model mimicking hypertensive heart disease is created via surgical interventions, such as by narrowing the aorta. Abdominal aortic constriction is a useful experimental technique to induce a pressure overload, which leads to heart failure. The surgery can be easily performed, without the need for chest opening or mechanical ventilation. Abdominal aortic constriction-induced cardiac pathology progresses gradually, making this model relevant to clinical hypertensive heart failure. Cardiac injury and remodeling can be observed 10 weeks after the surgery. The method described here provides a simple and effective approach to produce a hypertensive heart disease animal model that is suitable for studying disease mechanisms and for testing novel therapeutics.

A rat model of abdominal aortic constriction that induces cardiac hypertrophy and remodeling is described. An efficient, highly-reproducible, and minimally-invasive method is used to provide a simple yet useful platform for research in myocardial hypertrophy and dysfunction.

心脏重构通过大鼠腹主动脉缩窄的模型

Heart failure is one of the leading causes of death worldwide. It is a complex clinical syndromethat includes fatigue, dyspnea, exercise intolerance, and ...

Patch Angioplasty in the Rat Aorta or Inferior Vena Cava

Pericardial patches are commonly used in vascular surgery to close vessels. To facilitate studies of the neointimal hyperplasia that forms on the patch, we developed a rat model of patch angioplasty that can be used in either a vein or an artery, creating a patch venoplasty or a patch arterioplasty, respectively. Technical aspects of this model are discussed. The infra-renal IVC or aorta are dissected and then clamped proximally and distally. A 3 mm venotomy or arteriotomy is performed in the infrarenal inferior vena cava or aorta of 6 to 8 week-old Wistar rats. A bovine pericardial patch (3 mm x 1.5 mm x 0.6 mm) is then used to close the site using a 10-0 nylon suture. Compared to arterial patches, venous patches show increased neointimal thickness on postoperative day 7. This novel model of pericardial patch angioplasty can be used to examine neointimal hyperplasia on vascular biomaterials, as well as to compare the differences between the arterial and venous environments.

We have established a model of pericardial patch angioplasty that can be used in either small-diameter veins or arteries. This model can be used to compare venous and arterial neointimal hyperplasia formation.

血管补片在大鼠主动脉和下腔静脉

Pericardial patches are commonly used in vascular surgery to close vessels. To facilitate studies of the neointimal hyperplasia that forms on the patch, ...

Direct Re-implantation of Left Coronary Artery into the Aorta in Adults with Anomalous Origin of Left Coronary Artery from the Pulmonary Artery (ALCAPA)

Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) is a rare congenital anomaly which is one of leading causes of myocardial ischemia and infarction in children. If left untreated, it results in a 90% mortality rate in the first year of life. In patients who survive to the adulthood, the coronary steal phenomenon and retrograde left-sided coronary flow provide a substrate for chronic subendocardial ischemia, which may lead to left ventricular dysfunction, ischemic mitral regurgitation, malignant ventricular arrhythmias, and sudden cardiac death. The average age of life-threatening presentation is 33 years and of sudden cardiac death 31 years. Therefore, surgical correction is highly recommended as soon as the diagnosis is made, regardless of age. In adult-type ALCAPA originating from the right-facing sinus of the pulmonary artery, direct re-implantation of the ALCAPA into the aorta is the more physiologically sound repair technique to re-establish the dual-coronary perfusion system and is recommended. This protocol describes the technique of direct re-implantation of adult-type ALCAPA into the aorta.

Direct Re-implantation of Left Coronary Artery into the Aorta in Adults with Anomalous Origin of Left Coronary Artery from the Pulmonary Artery ALCAPA

Surgical correction of ALCAPA is highly recommended, regardless of age or the degree of intercoronary collateralization. This protocol presents a technique for the direct re-implantation of adult-type ALCAPA into the aorta to re-establish the dual-coronary perfusion. Whenever feasible, direct re-implantation is preferred to other surgical correction techniques.

左冠状动脉直接再注入与从肺动脉左冠状动脉起源异常成人主动脉（ALCAPA）

Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) is a rare congenital anomaly which is one of leading causes of myocardial ...

Balloon-based Injury to Induce Myointimal Hyperplasia in the Mouse Abdominal Aorta

The use of animal models is essential for a better understanding of MH, one major cause for arterial stenosis.In this article, we demonstrate a murine balloon denudation model, which is comparable with established vessel injury models in large animals. The aorta denudation model with balloon catheters mimics the clinical setting and leads to comparable pathobiological and physiological changes. Briefly, after performing a horizontal incision in the aorta abdominalis, a balloon catheter will be inserted into the vessel, inflated, and introduced retrogradely. Inflation of the balloon will lead to intima injury and overdistension of the vessel. After removing the catheter, the aortic incision will be closed with single stiches. The model shown in this article is reproducible, easy to perform, and can be established quickly and reliably. It is especially suitable for evaluating expensive experimental therapeutic agents, which can be applied in an economical fashion. By using different knockout-mouse strains, the impact of different genes on MH development can be assessed.

This article demonstrates a murine model to study the development of myointimal hyperplasia (MH) after aortic balloon injury.

球囊损伤诱发小鼠腹主动脉 Myointimal 增生的研究

The use of animal models is essential for a better understanding of MH, one major cause for arterial stenosis.In this article, we demonstrate a murine ...

Ultrasound Imaging of the Thoracic and Abdominal Aorta in Mice to Determine Aneurysm Dimensions

Contemporary high-resolution ultrasound instruments have sufficient resolution to facilitate the measurement of mouse aortas. These instruments have been widely used to measure aortic dimensions in mouse models of aortic aneurysms. Aortic aneurysms are defined as permanent dilations of the aorta, which occur most frequently in the ascending and abdominal regions. Sequential measurements of aortic dimensions by ultrasound are the principal approach for assessing the development and progression of aortic aneurysms in vivo. Although many reported studies used ultrasound imaging to measure aortic diameters as a primary endpoint, there are confounding factors, such as probe position and cardiac cycle, that may impact the accuracy of data acquisition, analysis, and interpretation. The purpose of this protocol is to provide a practical guide on the use of ultrasound to measure the aortic diameter in a reliable and reproducible manner. This protocol introduces the preparation of mice and instruments, the acquisition of appropriate ultrasound images, and data analysis.

Ultrasound imaging has become a common modality to determine the luminal dimensions of thoracic and abdominal aortic aneurysms in mice. This protocol describes the procedure to acquire reliable and reproducible two-dimensional ultrasound images of the ascending and abdominal aorta in mice.

小鼠胸腹主动脉超声检查确定动脉瘤大小

Contemporary high-resolution ultrasound instruments have sufficient resolution to facilitate the measurement of mouse aortas. These instruments have been ...

A Murine Model of Hemodialysis Access-Related Hand Dysfunction

Chronic kidney disease is a major public health problem, and the prevalence of end-stage renal disease (ESRD) requiring chronic renal replacement therapies such as hemodialysis continues to increase. Autogenous arteriovenous fistula (AVF) placement remains a primary vascular access option for ESRD patients. Unfortunately, approximately half of the hemodialysis patients experience dialysis access-related hand dysfunction (ARHD), ranging from subtle paresthesia to digital gangrene. Notably, the underlying biologic drivers responsible for ARHD are poorly understood, and no adequate animal model exists to elucidate the mechanisms and/or develop novel therapeutics for the prevention/treatment of ARHD. Herein, we describe a new mouse model in which an AVF is created between the left common iliac artery and vein, thereby facilitating the assessment of limb pathophysiology. The microsurgery includes vessel isolation, longitudinal venotomy, creation of arteriovenous anastomosis, and venous reconstruction. Sham surgeries include all the critical steps except for AVF creation. Iliac AVF placement results in clinically relevant alterations in central hemodynamics, peripheral ischemia, and impairments in hindlimb neuromotor performance. This novel preclinical AVF model provides a useful platform that recapitulates common neuromotor perturbations reported by hemodialysis patients, allowing researchers to investigate the mechanisms of ARHD pathophysiology and test potential therapeutics.

This protocol details the surgical steps of murine common iliac arteriovenous fistula creation. We developed this model to study hemodialysis access-related limb pathophysiology.

血液透析通路相关手功能障碍的小鼠模型

Chronic kidney disease is a major public health problem, and the prevalence of end-stage renal disease (ESRD) requiring chronic renal replacement ...

Robotic Cochlear Implantation for Direct Cochlear Access

Robot-assisted systems offer great potential for gentler and more precise cochlear implantation. In this article, we provide a comprehensive overview of the clinical workflow for robotic cochlear implantation using a robotic system specifically developed for a minimally invasive, direct cochlear access. The clinical workflow involves experts from various disciplines and requires training to ensure a smooth and safe procedure. The protocol briefly summarizes the history of robotic cochlear implantation. The clinical sequence is explained in detail, beginning with the assessment of patient eligibility and covering surgical preparation, preoperative planning with the special planning software, drilling of the middle ear access, intraoperative imaging to confirm the trajectory, milling of the inner ear access, insertion of the electrode array, and implant management. The steps that require special attention are discussed. As an example, the postoperative outcome of robotic cochlear implantation in a patient with advanced otosclerosis is presented. Finally, the procedure is discussed in the context of the authors' experience.

Robotic cochlear implantation is a procedure for minimally invasive inner ear access. Compared to conventional surgery, robotic cochlear implantation involves additional steps that need to be carried out in the operating room. In this article we give a description of the procedure and highlight the important aspects of robotic cochlear implantation.

用于直接访问人工耳蜗的机器人人工耳蜗植入

Robot-assisted systems offer great potential for gentler and more precise cochlear implantation. In this article, we provide a comprehensive overview of ...