Hello, I'm Dr.We we are at the cardiovascular Research Department in Beha Hospital. The following sequences will show you the different steps to induce and then to treat an abdominal arctic aneurysm in rat rat abdominal aneurysm. Induction with elatta has been described by nature in 1990.
In this laboratory, the same year par published the first cases of endovascular abdominal aneurysm repair In humans, we present the first endovascular exclusion after triple A induced by elatta in rats with a coronary covered balloon expendable and graft, A short isof fluorine anesthesia, followed by a panus pen. Barbital intraperitoneal injection induces a long anesthesia time. Skin is shaved then disinfected after op pubic incision.
Internal organs are placed in a wet compress in the left side of the animal. The peritoneum is not torn but smoothly cut to reduce adhesions, which may make the second step of the procedure more difficult. All the collaterals are ligated at the origin of the ata with a nine zero proline, the dissection should be as minimal as possible to reduce the risk of adhesions between the ATA and inferior vena cava.
When all the collaterals are ligated, a double loop silk is wrapped around the aorta, 15 millimeters below the left renal vein. Aorta must be fully dissected below the left renal vein and above the aortic bifurcation to allow self clamping aorta is clamped. Adventitia is removed at the place of the AOR autotomy for a clean stitching.
At the end of the procedure, a small AOR autotomy is performed. Blood is flushed from the aorta to prevent clot formation, which could embolize. When DEC clamping catheter is inserted until the proximal clamp, the silk is tightened to prevent catheter expulsion with the high or aortic pressure During injection.
When injection begins, the aortic diameter rapidly increases. It is important to maintain wall tension for optimal elastase infusion. At the end of the infusion, aortic wall is almost transparent and the catheter is visible reflecting a good diffusion of the elastase in the aortic wall.
When the infusion is finished, the silk is cut, aorta flush with saline and aorta. Autotomy is closed with a 10 zero proline after clamp removal. Adequate hemostasis is insured with manual pressure using a wet pack.
Rat abdominal wall is sutured with a continuous suture and the ceiling enclosed with interruptive sutures. Before the end of the anesthesia, a subcutaneous injection of carprofen is given to prevent pain. Inflator is used to deploy the stent at eight atmosphere pressures.
A silk or braided non-absorbable suture is used to clamp the aorta. We use at least three a traumatic clamps. We deploy the balloon expandable coronary stent graft with a diameter of three millimeters and the length of nine to 16 millimeters after as if of pubic incision Care should be triggered to avoid internal organs, which may be stuck to the wall from adhesions.
The aneurysm is expected to be close to the left renal vein. It's important to leave a long segment of normal aorta below the aneurysm when clamping to allow an easy stent graft insertion, and also to aid the closure of the atomy. Proximal neck is controlled with a double loopt suture and just proximal to the OR bifurcation stent graft choice depends on the aneurysm size.
Proximal and distal ceiling zones should be about two to three millimeters. Here we use a 12 millimeter stent. Graft aorta is clamped approximately and distally.
A large atomy is performed. The aorta isn't flushed. To maintain the position of the aneurysm thrombus, the stent graft is directly inserted.
When the shaft is stopped by the clamp, the suture is tightened around the aorta and the clamp removed. Suture tension allows progression of the stent through the aortic lumen. Until satisfactory position is achieved, the balloon is inflated at eight atmosphere pressures then deflated while tightening.
The proximal loop, blood is flushed from the stent graft. Then a clamp is placed just above the aneurysm to allow a careful aortic closure After fixation in glutaraldehyde and a resin block. HPS stain reveals mesenchymal cells outside the PTFE graft.
This demonstrates a regeneration process within the thrombus. The main limitation is the high frequency of vessel occlusion. Both the stent graft and aorta thrombose easily possibly due to interval injuries during stent graft insertion, and clots within the stent.Graft.
After deployment, aspirin, administration to the rats after the operation may prevent thrombus formation. This model of endovascular exclusion of an aortic aneurysm is the first to be described in the small animal. It'll have been of great help for improving the understanding of aneurysm remodeling in the excluded sac.
