Die Autoren danken Christiane Pahrmann für ihre technische Unterstützung. Diese Studie wurde von der Deutschen Stiftung für Herzforschung (F / 28/14) finanziert. DW wurde vom Travel Award von der International Society for Heart and Lung Transplantation unterstützt. TD erhielt die Else Kröner Exzellenzstipendium von der Else-Kröner-Fresenius-Stiftung (2012_EKES.04). SS erhielt ein Forschungsstipendium der Deutschen Forschungsgemeinschaft (DFG; DE2133 / 2-1, TD und SCHR992 / 3- 1, SCHR992 / 4-1, SS).

Die Tiere erhielten humane Pflege im Einklang mit dem Leitfaden für die Grundsätze von Labortieren, hergestellt durch das Institut für Labortierressourcen und durch die National Institutes of Health veröffentlicht. Alle Tier Protokolle wurden von der zuständigen Behörde ( &quot;Amt für Gesundheit und Verbraucherschutz, Hansestadt (Amt für Gesundheit und Verbraucherschutz) Hamburg&quot;) zugelassen. 1. Animal Care <ol><li> Erhalten Lewis-Ratten (LEW / GRL) Ratten und ROSA / Luciferase-LEW transgenen Ratten 300-350 g vom Institut für Labortiere wiegen. </li><li> Halten Sie die Ratten unter üblichen Bedingungen in belüfteten Schränken und füttern sie Standard-Rattenfutter und autoklaviert Wasser ad libitum. </li><li> Führen Sie eine Graft-Transplantation die ROSA / Luciferase-LEW transgenen Ratten als die Spender und die syngenen LEW / Crl Ratten als Empfänger verwendet wird. </li></ol> 2. Herstellung des Donor-Ratte <ol><li> Verwenden Sie ein inductIonenkammer eine Ratte mit Isofluran (2,5-3%) zu betäuben. </li><li> Legen Sie die Ratte auf den Rücken und halten die Anästhesie mit einer Gesichtsmaske für den Mund und Nase. Achten Sie auf ausreichende Narkosetiefe durch die Hinterfüße Kneifen und Überprüfung der Abwesenheit von Reflexen. Tragen Sie etwas Tierarzt Salbe in die Augen Trockenheit zu verhindern, während der Narkose. </li><li> Verbreiten Sie die Hinterbeine und fixieren ihre Position Klebeband. </li><li> Rasieren Sie den Leisten Haare mit einem Haarschneider und desinfizieren Sie die gesamte Fläche mit Povidon-Iod, gefolgt von 80% Ethanol. Wiederholen Sie den Desinfektionsschritt zweimal. HINWEIS: Der OP-Bereich, Gaze und chirurgische Instrumente sollten sterilisiert werden. Halten Sie einen sterilen Bereich während des gesamten Verfahrens und tragen Einweg, sterile OP-Handschuhe, Masken und Kappen. </li><li> Unter einem Mikroskop, einen vertikalen Schnitt entlang der linea inguinalis zuführen. Verwenden Sie zwei Pinzette vorsichtig die subkutanen Gewebe trennen und die V. epigastrica superficialis von seinem ori aussetzenGin auf die Oberschenkelvene. Sorgfältig isolieren die V. epigastrica superficialis aus den umliegenden Geweben. </li><li> Stopp des Blutflusses in der oberflächlichen Vene epigastric unter Verwendung von zwei Mikroschellen. </li><li> Ernte eine etwa 0,5 bis 1 cm-Segment der Vene durch vorsichtiges die isolierte Ader mit einer Pinzette Heben und Schneiden durch das Gefäß mit Mikroscheren. Lassen Sie die Mikroklammern auf dem Schiff Stumpf den Blutverlust zu verhindern. Legen Sie die entnommene Stück Vene auf steriler Gaze. eine 30-G-Nadel innerhalb eines Endes des geernteten Vene vorsichtig platzieren und das Gefäß mit Heparin (50 Einheiten / ml) spülen. HINWEIS: Behandeln Sie die Vene mit Sorgfalt und Vermeidung von Schäden beim Heben, Schneiden und Spülung. Stellen Sie sicher, das Transplantat mit der richtigen Menge an Heparin zu spülen. </li><li> Halten Sie das Gefäßsegment in 1% Lidocain auf Eis bis zur Transplantation in den Empfänger Ratte einen Gefäßspasmen zu verhindern. </li><li> Euthanize die Spender Ratte nach der Anästhesie bis 5% Isofluran erhöht. Nach 2-3 min, open den Bauch entlang der linea alba, schneiden durch die Membran, und entfernen Sie das Herz-Kreislauf zu stoppen. </li></ol> 3. Vorbereitung der Empfängerratte <ol><li> Anästhesieren und die Empfängerratte in der gleichen Weise wie der Spenderratte fixieren. </li><li> Rasur die mediale Seite der Schenkel mit einem Haarschneider und desinfizieren dreimal mit Povidon-Jod und 80% Ethanol. </li><li> Überwachen Sie die Tiefe der Anästhesie und sicherzustellen, dass es durch die Überprüfung das Fehlen von Reflexen ausreichend ist, wenn die Hinterfüße Kneifen. </li><li> Führen Sie eine mittlere Oberschenkel Schnitt vom Knie bis zur Leistenbeuge. Unter dem Mikroskop benutzen 2 Zange die Femoralarterie von der Umgebung zu trennen. </li><li> Verwenden Sie Mikro Klammern um den Blutfluss zu stoppen. Legen Sie die proximale Klemme zuerst durch die distale Klammer gefolgt. </li><li> Schneiden Sie ein kurzes Segment der geklemmten Femoralarterie mit Mikroschere aus und entsorgen. Verkürzen Sie die verbleibenden arteriellen Stumpf mit Mikroschere, eine Lücke zu schaffen, ist1-2 mm größer als die Vene Graft. Spülen Sie den arteriellen Stumpf mit Heparin eine 30 G Nadel. HINWEIS: Wenn die Adventitia geringfügig über den Gefäßstumpf ragt, Zangen verwenden Sie es über das Ende des Schiffes leicht zu ziehen und ein Stück entfernen. </li><li> Legen Sie die geernteten Vene aus Schritt 2.8 zwischen den arteriellen Stümpfe und die Länge so einstellen, dass sie in geeigneter Weise in den Spalt passt. Beachten Sie die Richtung der Vene. </li><li> Führen Sie die proximale Anastomose zuerst eine 10-0 Prolene Naht verwendet wird. Führen Sie einzelne Stiche in der angegebenen Reihenfolge (Abbildung 1D). Beginnen mit einer Naht auf jeder lateralen Seite, bevor sie auf der Bauchseite drei Fäden hinzugefügt wird. Danach legen drei Maschen auf der dorsalen Seite des Schiffes die Anastomose zu vervollständigen. </li><li> Verbinden Sie die distale Gefäße mit dem Transplantat mit der gleichen Technik wie für die proximale Anastomose beschrieben in Schritt 3.8. Wieder mit einer Naht auf jeder Seite beginnen und dann auf der ventralen sid drei Nähte platzierene und der dorsalen Seite. </li><li> Legen Sie zwei 1-ml-Spritzen mit Fibrinkleber Komponente 1 und 2. Heben Sie vorsichtig das Transplantat mit einer Pinzette und fallen etwa 100 ul Fibrinkleber Komponente 1 unter dem Transplantat, gefolgt von Komponente 2. HINWEIS: Stellen Sie sicher, dass die Komponenten 1 und 2 in einem 1 angewendet werden: 1-Verhältnis. </li><li> Legen Sie das Transplantat wieder in seine Position und fallen weitere 100 &amp; mgr; l der Komponenten 1 und 2 auf der Oberseite des Transplantats. Achten Sie darauf, dass der Klebstoff sowohl das Transplantat und die Anastomose abdeckt, um Anastomoseninsuffizienzen und Überdehnung der Vene Transplantat zu verhindern. </li><li> Öffnen Sie vorsichtig die distale Klammer, durch die proximalen gefolgt. </li><li> Bestätigen einer erfolgreichen Operation durch einen sichtbaren Impuls in der transplantierten Vene und Arterie distal des Transplantats zu überprüfen. </li><li> Überschüssiges Klebstoff, der Hautverschluss verhindert. Verwenden einer Pinzette, um das gehärtete Klebstoff zu heben und den Überschuss mit Mikroschere entfernen. Schließen Sie die Hautschichten mit 5-0 Prolene Fäden. </li><li> Injizieren 4-5 mg / kg Carprofen subkutan, bevor der Ratte zu wecken. Nicht das Tier unbeaufsichtigt lassen, bis es genügend Bewusstsein zu halten Brustlage wiedergewonnen hat. Halten Sie das Tier in einem Käfig, bis es vollständig zurückgewonnen wird. </li><li> In Metamizol dem Trinkwasser (50 mg Metamizol pro 100 ml) als Schmerzmittel für die folgenden 3 Tage und überwachen täglich das Tier. </li></ol> 4. Duplex-Sonographie HINWEIS: Verwenden Sie duxplex Sonographie Blutfluss nicht-invasiv in Ratten 14 sichtbar zu machen. <ol><li> Betäuben eine Ratte in einer Induktionskammer (Isofluran 2%). Legen Sie die Ratte auf den Rücken und halten Anästhesie mit einer Gesichtsmaske bedeckt die Nase. </li><li> Verwenden Sie Haarschneidemaschinen und Enthaarungscreme die Haare um den Bereich des Oberschenkels zu entfernen. </li><li> Bewerben Ultraschall-Gel auf den Oberschenkel. Stellen Sie sicher, dass es keine Luftblasen. Erwerben Duplexsonographie Bilder eine MS 400 Wandler mit (Mittenfrequenz: 30 MHz) mit einer Bildrate von 230 bis 400 Bilder / Sek. </li></ol> 5. Histopathologie HINWEIS: Ernte und färben das Gefäß mit Masson Trichrom Färbung für morphometrische Analyse 15. <ol><li> Befestigen Sie das entnommene Gefäß in 4% Paraformaldehyd über Nacht und entwässern es in Konzentrationen von Ethanol zu erhöhen. Einbetten der Probe in Paraffin und schneiden Sie es in 5 &amp; mgr; m dicke Scheiben mit einem Mikrotom. HINWEIS: Paraformaldehyd ist giftig und sollte mit besonderer Sorgfalt behandelt werden. </li><li> Entparaffinieren Dias vor ihnen mit Trichromfärbung Lösung Färbung. Entwässern die gefärbten Objektträger, deaktivieren Sie sie mit Xylol und montieren sie Medium bei der Montage. Nachdem die Folien Trocknen sehen Sie die Proben mit einem Mikroskop. </li></ol> 6. Biolumineszenz-Bildgebung (BLI) HINWEIS: Die postoperative Transplantat wurde im Laufe der Zeit in vivo verfolgt durch Biolumineszenz - Messsignal 16. <ol><li> Man löst 1 g D-Luciferin-Kaliumsalz in 22 ml PBS und injizieren sie intraperitoneal in der Ratte (375 mg / kg Körpergewicht). Warten Sie 15 min für das Luciferin in dem Tier zu zirkulieren. </li><li> Legen Sie die Ratte in einer Echtzeit-Biolumineszenz-Quantifizierungssystem und auf das Biolumineszenz-Signal. </li></ol>

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The authors have nothing to disclose.

Dieses Video zeigt eine Ratte Vene Zwischen Modell Venentransplantatverlust zu untersuchen und für die Erforschung der zugrunde liegenden pathologischen Prozesse und die Erprobung neuer Medikamente oder Therapieoptionen zu ermöglichen. Anästhesie ist ein entscheidender Aspekt der chirurgischen Verfahren. Eine kontinuierliche inhalative Anästhesiesystem wird empfohlen, da dies eine sichere und einfache Methode ist, vor allem bei längeren Operationen. Dies kann während der Trainingsphase...

Koronare Herzerkrankungen und deren Komplikationen gehören zu den führenden Todesursachen weltweit. Aktuelle Therapiestrategien konzentrieren sich auf die Wiederherstellung des Blutflusses, entweder durch die verengte Gefäß dilating oder durch einen Bypass zu schaffen. Koronaren Bypass-Operation (CABG) Venentransplantaten wurde erstmals im Jahr 1968 beschrieben und wurde im Laufe der Jahre verfeinert. Abgesehen von der Revaskularisierung des linken vorderen absteigenden Koronararterie, Vena saphena Leitungen werden am häufigsten 1 verwendet. Allerdings bleibt Graft Durchgängigkeit die Achillesferse der Vena saphena-Transplantate (SVG). Ein Jahr nach der Operation, ist Graft Durchgängigkeit 85% und fiel auf 61% nach zehn Jahren 2,3. Die Enthüllung der pathophysiologischen Mechanismen und Ursachen für den Verlust SVG Durchgängigkeit ist daher eine wichtige Aufgabe. Dieses Video zeigt eine Ratte Vene Zwischen Modell Venentransplantatverlust zu untersuchen. Die allgemeinen Ziele dieser Methode sind die zugrunde liegenden pathobiologischen zu erkundenund Physiologische Prozesse während der Krankheitsprogression und ein geeignetes Modell für Arzneimittel oder therapeutische Option Tests zu entwickeln. die V. epigastrica superficialis in das arterielle System, dieses Modell ahmt die klinische Einstellung der koronaren Bypass-Operation durch Transplantation. Chirurgische Trauma, Ischämie und Wandspannung sind wichtige Auslöser der pathologischen Gefäßveränderungen und werden im Modell beschrieben nachgeahmt. Verschiedene Modelle und Arten sind vorhanden Venentransplantat Durchgängigkeit Verlust zu untersuchen. Großtiermodellen, wie Schweine 4, Schafe 5, 6 Hunden und Affen 7 ähneln menschlichen Gefäßes und anatomischer Strukturen und so komplexe therapeutische Strategien, wie beispielsweise Bypass - Stenting oder neue chirurgische Techniken zu ermöglichen, werden 8 getestet. Allerdings spezielles Gehäuse, Ausrüstung und Personal erforderlich sind. Darüber hinaus hohe Kosten und die Notwendigkeit für eine zusätzliche Anästhesist während eines chirurgischen Eingriffs zu behindern ihre breitere Anwendung. Smalle Tiere, einschließlich Ratten, sind einfach nicht spezielles Gehäuse zu handhaben, benötigen, und haben überschaubaren Kosten. Im Vergleich zu Maus - Modellen 9,10 haben Rattenmodelle den Vorteil der besseren Handhabbarkeit und damit weniger Variabilität in den Ergebnissen. Ratten sind physiologisch und genetisch ähnlich wie beim Menschen als Mäuse 11,12. Zudem sind die meisten Wildtyp - Mäusen entwickeln nur begrenzte myointima 13, die Mausmodelle machen anfällig II Fehler zu geben. Die Histologie der Hauptmaus Venen, wie die inferior vena cava, besteht nur aus wenigen Zellschichten und rendert frühzeitige Bewertung schwierig 13. Ein weiterer Nachteil ist die geringe Menge an Gewebe für eine nachfolgende Analyse nach Graft Genesung. Das Modell in diesem Video beschrieben ist reproduzierbar, kostengünstig und einfach durchzuführen, und es kann schnell und zuverlässig hergestellt werden. Es eignet sich besonders für teure experimentelle therapeutische Mittel, wie virale Vektoren Auswertenfür die Gentherapie, in wirtschaftlicher Weise.

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			<td height="17" style="height:17px;width:236px;">Rat LEW/Crl</td>
			<td style="width:183px;">Charles River</td>
			<td style="width:145px;">Stock number 004</td>
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			<td height="51" style="height:51px;width:236px;">Rat LEW-Tg(Gt(ROSA)26Sor- 1 
			luc)11Jmsk</td>
			<td style="width:183px;">Institute of laboratory animals, Kyoto University, Japan</td>
			<td style="width:145px;">NBPR rat number 0299</td>
			<td style="width:156px;">http://www.anim.med.kyoto-u.ac.jp/NBR/</td>
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		<tr height="17">
			<td height="17" style="height:17px;">PFA 4%</td>
			<td>Electron Microscopy Sciences</td>
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			<td align="right">20%</td>
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			<td height="17" style="height:17px;">hair clipper</td>
			<td>WAHL</td>
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			<td height="38" style="height:38px;">Forene</td>
			<td>AbbVie</td>
			<td style="width:145px;">PZN 10182054 Art.Nr.: B506</td>
			<td>Isoflurane</td>
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			<td height="17" style="height:17px;">microsurgical clamp</td>
			<td>Fine Science Tools</td>
			<td>18055-04</td>
			<td>Micro-Serrefine - 4mm</td>
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			<td height="17" style="height:17px;">clamp applicator</td>
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			<td height="17" style="height:17px;">hair removal creme</td>
			<td>Rufin cosmetic</td>
			<td align="right">27618</td>
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			<td height="17" style="height:17px;">Povidone-Iodine</td>
			<td>Betadine Purdue Pharma</td>
			<td>NDC:67618-152</td>
			<td></td>
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		<tr height="17">
			<td height="17" style="height:17px;">10-0 Ethilon suture</td>
			<td>Ethicon</td>
			<td>2814G</td>
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		<tr height="17">
			<td height="17" style="height:17px;">5-0 prolene suture</td>
			<td>Ethicon</td>
			<td>EH7229H</td>
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			<td height="17" style="height:17px;">Rimadyl</td>
			<td>Pfizer</td>
			<td style="width:145px;">400684.00.00</td>
			<td>Carprofen</td>
		</tr>
		<tr height="17">
			<td height="17" style="height:17px;">Novaminsulfon</td>
			<td>Ratiopharm</td>
			<td>PZN 03530402</td>
			<td>Metamizole</td>
		</tr>
		<tr height="17">
			<td height="17" style="height:17px;">Heparin</td>
			<td>Rotexmedica</td>
			<td>PZN: 3862340</td>
			<td>25.000 I.E./mL</td>
		</tr>
		<tr height="17">
			<td height="17" style="height:17px;">Xylocain 1%</td>
			<td>AstraZeneca</td>
			<td>PZN: 1137907</td>
			<td>Lidocain</td>
		</tr>
		<tr height="38">
			<td height="38" style="height:38px;">EVICEL</td>
			<td>J&#38;J Med.Ethicon Biosur</td>
			<td style="width:145px;">PZN 7349697 Art. Nr.:EVK01DE</td>
			<td>fibrin glue</td>
		</tr>
		<tr height="37">
			<td height="37" style="height:37px;">NaCl 0,9%</td>
			<td>B.Braun</td>
			<td style="width:145px;">PZN 06063042 Art. Nr.: 3570160</td>
			<td></td>
		</tr>
		<tr height="34">
			<td height="34" style="height:34px;width:236px;">Vevo 770 high-resolution in vivo micro-imaging system</td>
			<td>VisualSonics</td>
			<td></td>
			<td>duplex sonography</td>
		</tr>
		<tr height="17">
			<td height="17" style="height:17px;">Ecogel 100 ultrasound gel</td>
			<td>Eco-med</td>
			<td>30GB</td>
			<td></td>
		</tr>
		<tr height="17">
			<td height="17" style="height:17px;">D-Luciferin Firefly, potassium salt</td>
			<td>Biosynth</td>
			<td>L-8220</td>
			<td></td>
		</tr>
		<tr height="17">
			<td height="17" style="height:17px;">PBS pH 7,4</td>
			<td>Gibco</td>
			<td>10010023</td>
			<td></td>
		</tr>
		<tr height="17">
			<td height="17" style="height:17px;">Xenogen Ivis 200</td>
			<td>Perkin Elmer</td>
			<td></td>
			<td>bioluminescence imaging</td>
		</tr>
		<tr height="17">
			<td height="17" style="height:17px;">Weigerts iron hematoxylin Kit</td>
			<td>Merck</td>
			<td>1.15973.0002</td>
			<td>Trichrome staining</td>
		</tr>
		<tr height="17">
			<td height="17" style="height:17px;">Resorcine-Fuchsine Weigert</td>
			<td>Waldeck</td>
			<td>2.00E-30</td>
			<td>Trichrome staining</td>
		</tr>
		<tr height="17">
			<td height="17" style="height:17px;">Acid Fuchsin</td>
			<td>Sigma-Aldrich</td>
			<td>F8129-25G</td>
			<td>Trichrome staining</td>
		</tr>
		<tr height="17">
			<td height="17" style="height:17px;">Ponceau S solution</td>
			<td>Serva Electrophoresis</td>
			<td>33427</td>
			<td>Trichrome staining</td>
		</tr>
		<tr height="17">
			<td height="17" style="height:17px;">Azophloxin</td>
			<td>Waldeck</td>
			<td>1B-103</td>
			<td>Trichrome staining</td>
		</tr>
		<tr height="17">
			<td height="17" style="height:17px;width:236px;">Molybdatophosphoric acid hydrate</td>
			<td>Merck</td>
			<td>1.00532.0100</td>
			<td>Trichrome staining</td>
		</tr>
		<tr height="17">
			<td height="17" style="height:17px;">Orange G</td>
			<td>Waldeck</td>
			<td>1B-221</td>
			<td>Trichrome staining</td>
		</tr>
		<tr height="17">
			<td height="17" style="height:17px;">Light Green SF</td>
			<td>Waldeck</td>
			<td>1B-211</td>
			<td>Trichrome staining</td>
		</tr>
		<tr height="17">
			<td height="17" style="height:17px;">Vitro-Clud</td>
			<td>Langenbrinck</td>
			<td>04-0001</td>
			<td></td>
		</tr>
		<tr height="17">
			<td height="17" style="height:17px;">Glacial Acetic Acid</td>
			<td>Sigma-Aldrich</td>
			<td align="right">537020</td>
			<td></td>
		</tr>
		<tr height="17">
			<td height="17" style="height:17px;">37% HCl</td>
			<td>Sigma-Aldrich</td>
			<td>H1758</td>
			<td></td>
		</tr>
		<tr height="17">
			<td height="17" style="height:17px;">Xylene</td>
			<td>Th. Geyer</td>
			<td align="right">3410</td>
			<td></td>
		</tr>
		<tr height="17">
			<td height="17" style="height:17px;">Paraffin</td>
			<td>Leica biosystems</td>
			<td>REF 39602004</td>
			<td></td>
		</tr>
		<tr height="17">
			<td height="17" style="height:17px;">Ethanol absolute</td>
			<td>Th. Geyer</td>
			<td align="right">2246</td>
			<td></td>
		</tr>
		<tr height="17">
			<td height="17" style="height:17px;">Ethanol 96%</td>
			<td>Th. Geyer</td>
			<td align="right">2295</td>
			<td></td>
		</tr>
		<tr height="17">
			<td height="17" style="height:17px;">Ethanol 70%</td>
			<td>Th. Geyer</td>
			<td align="right">2270</td>
			<td></td>
		</tr>
		<tr height="17">
			<td height="17" style="height:17px;">Slide Rack</td>
			<td>Ted Pella</td>
			<td align="right">21057</td>
			<td></td>
		</tr>
		<tr height="17">
			<td height="17" style="height:17px;">Staining dish</td>
			<td>Ted Pella</td>
			<td align="right">21075</td>
			<td></td>
		</tr>
		<tr height="17">
			<td height="17" style="height:17px;">Bepanthen Eye and Nose ointment</td>
			<td>Bayer</td>
			<td align="right">1578675</td>
			<td>Eye ointment</td>
		</tr>
	</tbody>
</table>

vein interposition model: a suitable model to study bypass graft patency

Bypass grafting is an established treatment method for coronary artery disease. Graft patency continues to be the Achilles heel of saphenous vein grafts. Research models for bypass graft failure are essential for a better understanding of pathobiological and pathophysiological processes during graft patency loss. Large animal models, such as pigs or sheep, resemble human anatomical structures but require special facilities and equipment. This video describes a rat vein interposition model to investigate vein graft patency loss. Rats are inexpensive and easy to handle. Compared to mouse models, the convenient size of rats permits better operability and enables a sufficient amount of material to be obtained for further diverse analysis. In brief, the inferior epigastric vein of a donor rat is harvested and used to replace a segment of the femoral artery. Anastomosis is conducted via single stitches and sealed with fibrin glue. Graft patency can be monitored non-invasively using duplex sonography. Myointimal hyperplasia, which is the main cause for graft patency loss, develops progressively over time and can be calculated from histological cross sections.

Die Ratte Vene Zwischen Modell geeignet ist, die Entwicklung von myointima Hyperplasie und Venentransplantatversagen zu untersuchen. Tiere erholen gut von der Operation und zeigen eine hervorragende körperliche Verfassung nach der Operation. Abbildung 1 zeigt die wichtigsten Operationsschritte. Nach dem Hautschnitt entlang der linea inguinalis sind die epigastric oberflächliche Vene und Arteria femoralis (Abbildung 1A) identifiziert. Ernten des Transplantats sollte sorgfältig durchge...

Watch this Scientific Journal Video about Vein Interposition Model: A Suitable Model to Study Bypass Graft Patency at JoVE.com

Vein Interposition Model: A Suitable Model to Study Bypass Graft Patency

This video demonstrates a model to study the development of myointimal hyperplasia after venous interposition surgery in rats.

Vein Interposition Modell: ein geeignetes Modell zur Untersuchung Bypass Graft Durchgängigkeit

Bypass grafting is an established treatment method for coronary artery disease. Graft patency continues to be the Achilles heel of saphenous vein grafts. ...

vein-interposition-model-suitable-model-to-study-bypass-graft

Research

JoVE Journal

Medicine

8.7K Aufrufe.  University Heart Center Hamburg. This video demonstrates a model to study the development of myointimal hyperplasia after venous interposition surgery in rats. 

Serie: Vein Interposition Model: A Suitable Model to Study Bypass Graft Patency

Training a Sophisticated Microsurgical Technique: Interposition of External Jugular Vein Graft in the Common Carotid Artery in Rats

Neointimal hyperplasia is one the primary causes of stenosis in arterialized veins that are of great importance in arterial coronary bypass surgery, in peripheral arterial bypass surgery as well as in arteriovenous fistulas.1-5 The experimental procedure of vein graft interposition in the common carotid artery by using the cuff-technique has been applied in several research projects to examine the aetiology of neointimal hyperplasia and therapeutic options to address it. 6-8 The cuff prevents vessel anastomotic remodeling and induces turbulence within the graft and thereby the development of neointimal hyperplasia.
Using the superior caval vein graft is an established small-animal model for venous arterialization experiment.9-11 This current protocol refers to an established jugular vein graft interposition technique first described by Zou et al., 9 as well as others.12-14 Nevertheless, these cited small animal protocols are complicated.
To simplify the procedure and to minimize the number of experimental animals needed, a detailed operation protocol by video training is presented. This video should help the novice surgeon to learn both the cuff-technique and the vein graft interposition. Hereby, the right external jugular vein was grafted in cuff-technique in the common carotid artery of 21 female Sprague Dawley rats categorized in three equal groups that were sacrificed on day 21, 42 and 84, respectively. Notably, no donor animals were needed, because auto-transplantations were performed. The survival rate was 100 % at the time point of sacrifice. In addition, the graft patency rate was 60 % for the first 10 operated animals and 82 % for the remaining 11 animals. The blood flow at the time of sacrifice was 8&plusmn;3 ml/min. In conclusion, this surgical protocol considerably simplifies, optimizes and standardizes this complicated procedure. It gives novice surgeons easy, step-by-step instruction, explaining possible pitfalls, thereby helping them to gain expertise fast and avoid useless sacrifice of experimental animals.

Neointimal hyperplasia is the primary cause of stenosis in arterialized veins. We propose a new protocol whereby the right external jugular vein is grafted using the cuff technique in the common carotid artery of Sprague Dawley rats. The survival rate was 100 % at the time point of sacrifice.

Trainieren eines Sophisticated mikrochirurgische Technik: Interposition der Vena jugularis externa Graft in der Arteria carotis communis bei Ratten

Neointimal hyperplasia is one the primary causes of stenosis in arterialized veins that are of great importance in arterial coronary bypass surgery, in ...

Forschung

Medizin

Adult Mouse Venous Hypertension Model: Common Carotid Artery to External Jugular Vein Anastomosis.

The understanding of the pathophysiology of brain arteriovenous malformations and arteriovenous fistulas has improved thanks to animal models. A rat model creating an artificial fistula between the common carotid artery (CCA) and the external jugular vein (EJV) has been widely described and proved technically feasible. This construct provokes a consistent cerebral venous hypertension (CVH), and therefore has helped studying the contribution of venous hypertension to formation, clinical symptoms, and prognosis of brain AVMs and dural AVFs. Equivalent mice models have been only scarcely described and have shown trouble with stenosis of the fistula. An established murine model would allow the study of not only pathophysiology but also potential genetic therapies for these cerebrovascular diseases.
We present a model of arteriovenous fistula that produces a durable intracranial venous hypertension in the mouse. Microsurgical anastomosis of the murine CCA and EJV can be difficult due to diminutive anatomy and frequently result in a non-patent fistula. In this step-by-step protocol we address all the important challenges encountered during this procedure. Avoiding excessive retraction of the vein during the exposure, using 11-0 sutures instead of 10-0, and making a carefully planned end-to-side anastomosis are some of the critical steps. Although this method requires advanced microsurgical skills and a longer learning curve that the equivalent in the rat, it can be consistently developed.
This novel model has been designed to integrate transgenic mouse techniques with a previously well-established experimental system that has proved useful to study brain AVMs and dural AVFs. By opening the possibility of using transgenic mice, a broader spectrum of valid models can be achieved and genetic treatments can also be tested. The experimental construct could also be further adapted to the study of other cerebrovascular diseases related with venous hypertension such as migraine, transient global amnesia, transient monocular blindness, etc.

We describe a method for creating a reliable model of cerebral venous hypertension in the adult mouse. This model has been widely described and tested in the rat. This new counterpart in the mice opens the possibility of using genetic modified animals and thereby broadens the applications of the model.

Erwachsene Maus venöse Bluthochdruckmodell: A. carotis communis, um äußere Jugularvene Anastomose.

The understanding of the pathophysiology of brain arteriovenous malformations and arteriovenous fistulas has improved thanks to animal models. A rat model ...

A Human Ex Vivo Atherosclerotic Plaque Model to Study Lesion Biology

Atherosclerosis is a chronic inflammatory disease of the vasculature. There are various methods to study the inflammatory compound in atherosclerotic lesions. Mouse models are an important tool to investigate inflammatory processes in atherogenesis, but these models suffer from the phenotypic and functional differences between the murine and human immune system. In vitro cell experiments are used to specifically evaluate cell type-dependent changes caused by a substance of interest, but culture-dependent variations and the inability to analyze the influence of specific molecules in the context of the inflammatory compound in atherosclerotic lesions limit the impact of the results. In addition, measuring levels of a molecule of interest in human blood helps to further investigate its clinical relevance, but this represents systemic and not local inflammation. Therefore, we here describe a plaque culture model to study human atherosclerotic lesion biology ex vivo. In short, fresh plaques are obtained from patients undergoing endarterectomy or coronary artery bypass grafting and stored in RPMI medium on ice until usage. The specimens are cut into small pieces followed by random distribution into a 48-well plate, containing RPMI medium in addition to a substance of interest such as cytokines or chemokines alone or in combination for defined periods of time. After incubation, the plaque pieces can be shock frozen for mRNA isolation, embedded in Paraffin or OCT for immunohistochemistry staining or smashed and lysed for western blotting. Furthermore, cells may be isolated from the plaque for flow cytometry analysis. In addition, supernatants can be collected for protein measurement by ELISA. In conclusion, the presented ex vivo model opens the possibility to further study inflammatory lesional biology, which may result in identification of novel disease mechanisms and therapeutic targets.

A Human Ex Vivo Atherosclerotic Plaque Model to Study Lesion Biology

Atherosclerosis is a chronic inflammatory process. This manuscript illustrates an easy to use ex vivo model to investigate fresh carotid or coronary artery plaques. The ex vivo model allows for the investigation of potential substances on the inflammatory milieu in human atherosclerotic lesions and results can be analyzed by various methods.

A Human<em&gt; Ex Vivo</em&gt; Atherosklerotischen Plaque Modell zur Läsion Biologie studieren

Atherosclerosis is a chronic inflammatory disease of the vasculature. There are various methods to study the inflammatory compound in atherosclerotic ...

Implantation of Inferior Vena Cava Interposition Graft in Mouse Model

Biodegradable scaffolds seeded with bone marrow mononuclear cells (BMCs) are often used for reconstructive surgery to treat congenital cardiac anomalies. The long-term clinical results showed excellent patency rates, however, with significant incidence of stenosis. To investigate the cellular and molecular mechanisms of vascular neotissue formation and prevent stenosis development in tissue engineered vascular grafts (TEVGs), we developed a mouse model of the graft with approximately 1 mm internal diameter. First, the TEVGs were assembled from biodegradable tubular scaffolds fabricated from a polyglycolic acid nonwoven felt mesh coated with &#949;-caprolactone and L-lactide copolymer. The scaffolds were then placed in a lyophilizer, vacuumed for 24 hr, and stored in a desiccator until cell seeding. Second, bone marrow was collected from donor mice and mononuclear cells were isolated by density gradient centrifugation. Third, approximately one million cells were seeded on a scaffold and incubated O/N. Finally, the seeded scaffolds were then implanted as infrarenal vena cava interposition grafts in C57BL/6 mice. The implanted grafts demonstrated excellent patency (&#62;90%) without evidence of thromboembolic complications or aneurysmal formation. This murine model will aid us in understanding and quantifying the cellular and molecular mechanisms of neotissue formation in the TEVG.

To improve our knowledge of cellular and molecular neotissue formation, a murine model of the TEVG was recently developed. The grafts were implanted as infrarenal vena cava interposition grafts in C57BL/6 mice. This model achieves similar results to those achieved in our clinical investigation, but over a far shortened time-course.

Die Implantation von Vena Cava Interposition Graft in Maus-Modell

Biodegradable scaffolds seeded with bone marrow mononuclear cells (BMCs) are often used for reconstructive surgery to treat congenital cardiac anomalies. ...

Cardiopulmonary Bypass in a Mouse Model: A Novel Approach

As prolonged cardiopulmonary bypass becomes more essential during cardiac interventions, an increasing clinical demand arises for procedure optimization and for minimizing organ damage resulting from prolonged extracorporal circulation. The goal of this paper was to demonstrate a fully functional and clinically relevant model of cardiopulmonary bypass in a mouse. We report on the device design, perfusion circuit optimization, and microsurgical techniques. This model is an acute model, which is not compatible with survival due to the need for multiple blood drawings. Because of the range of tools available for mice (e.g., markers, knockouts, etc.), this model will facilitate investigation into the molecular mechanisms of organ damage and the effect of cardiopulmonary bypass in relation to other comorbidities.

This paper describes how to perform cardiopulmonary bypass in mice. This novel model will facilitate the investigation of the molecular mechanisms involved in organ damage.

Kardiopulmonalen Bypass in einem Mausmodell: ein neuer Ansatz

As prolonged cardiopulmonary bypass becomes more essential during cardiac interventions, an increasing clinical demand arises for procedure optimization ...

Surgical Swine Model of Chronic Cardiac Ischemia Treated by Off-Pump Coronary Artery Bypass Graft Surgery

Chronic cardiac ischemia that impairs cardiac function, but does not result in infarct, is termed hibernating myocardium (HM). A large clinical subset of coronary artery disease (CAD) patients have HM, which in addition to causing impaired function, puts them at higher risk for arrhythmia and future cardiac events. The standard treatment for this condition is revascularization, but this has been shown to be an imperfect therapy. The majority of pre-clinical cardiac research focuses on infarct models of cardiac ischemia, leaving this subset of chronic ischemia patients largely underserved. To address this gap in research, we have developed a well-characterized and highly reproducible model of hibernating myocardium in swine, as swine are ideal translational models for human heart disease. In addition to creating this unique disease model, we have optimized a clinically relevant treatment model of coronary artery bypass surgery in swine. This allows us to accurately study the effects of bypass surgery on heart disease, as well as investigate additional or alternate therapies. This model surgically induces single vessel stenosis by implanting a constrictor on the left anterior descending (LAD) artery in a young pig. As the pig grows, the constrictor creates a gradual stenosis, resulting in chronic ischemia with impaired regional function, but preserving tissue viability. Following the establishment of the hibernating myocardium phenotype, we perform off-pump coronary artery bypass graft surgery to revascularize the ischemic region, mimicking the gold-standard treatment for patients in the clinic.

This protocol presents a surgical large animal model of chronic, single vessel ischemia that results in regional abnormalities but does not create infarct, known as hibernating myocardium. Following establishment of chronic ischemia, animals are treated with off-pump LIMA-LAD coronary artery bypass graft surgery to revascularize the ischemic tissue.

Chirurgische Schweine Modell der chronischen kardialen Ischämie von Off Pump Coronary Artery Bypass Graft-Chirurgie behandelt

Chronic cardiac ischemia that impairs cardiac function, but does not result in infarct, is termed hibernating myocardium (HM). A large clinical subset of ...

A Rabbit Model of Durable Transgene Expression in Jugular Vein to Common Carotid Artery Interposition Grafts

Vein graft bypass surgery is a common treatment for occlusive arterial disease; however, long-term success is limited by graft failure due to thrombosis, intimal hyperplasia, and atherosclerosis. The goal of this article is to demonstrate a method for placing bilateral venous interposition grafts in a rabbit, then transducing the grafts with a gene transfer vector that achieves durable transgene expression. The method allows the investigation of the biological roles of genes and their protein products in normal vein graft homeostasis. It also allows the testing of transgenes for the activities that could prevent vein graft failure, e.g., whether the expression of a transgene prevents the neointimal growth, reduces the vascular inflammation, or reduces atherosclerosis in rabbits fed with a high-fat diet. During an initial survival surgery, the segments of right and left external jugular vein are excised and placed bilaterally as reversed end-to-side common carotid artery interposition grafts. During a second survival surgery, performed 28 days later, each of the grafts is isolated from the circulation with vascular clips and the lumens are filled (via an arteriotomy) with a solution containing a helper-dependent adenoviral (HDAd) vector. After a 20-min incubation, the vector solution is aspirated, the arteriotomy is repaired, and flow is restored. The veins are harvested at time points dictated by individual experimental protocols. The 28-day delay between the graft placement and the transduction is necessary to ensure the adaptation of the vein graft to the arterial circulation. This adaptation avoids rapid loss of transgene expression that occurs in vein grafts transduced before or immediately after grafting. The method is unique in its ability to achieve durable, stable transgene expression in grafted veins. Compared to other large animal vein graft models, rabbits have advantages of low cost and easy handling. Compared to rodent vein graft models, rabbits have larger and easier-to-manipulate blood vessels that provide abundant tissue for analysis.

This method describes the placement of interposition vein grafts in rabbits, the transduction of the grafts, and the achievement of durable transgene expression. This allows the investigation of physiological and pathological roles of transgenes and their protein products in grafted veins, and testing of gene therapies for vein graft disease.

Ein Kaninchen-Modell der dauerhafte Transgene Ausdruck in Halsschlagader, gemeinsame Halsschlagader Interposition Grafts

Vein graft bypass surgery is a common treatment for occlusive arterial disease; however, long-term success is limited by graft failure due to thrombosis, ...

Isometric Contractility Measurement of the Mouse Mesenteric Artery Using Wire Myography

The wire myograph technique is used to assess the contractility of vascular smooth muscles in response to depolarization, GPCR agonists/inhibitors and drugs. It is widely used in many studies on the physiological functions of vascular smooth muscle, the pathogenesis of vascular diseases such as hypertension, and the development of smooth muscle relaxant drugs. The mouse is a widely used model animal with a large pool of disease models and genetically modified strains. We introduced this method to measure the isometric contraction of mouse mesenteric artery in detail. A 1.4-mm segment of mouse mesenteric resistance artery was isolated and mounted on a myograph chamber by passing two steel wires through its lumen. After equilibration and normalization steps, the vessel segment was potentiated by a high-K+ solution twice prior to the contraction assay. As an example of the application of this method in drug development, we measured the relaxant effect of a novel natural substance, neoliensinine, isolated from a Chinese herb, embryos of the lotus seed (Nelumbo nucifera Gaertn.) on mouse mesenteric arteries. The vessel segments mounted on the myograph chamber were stimulated with a high-K+ solution. When the force tension reached a stable sustained phase, cumulative doses of neoliensinine were added to the chamber. We found that neoliensinine had a dose-dependent relaxant effect on smooth muscle contraction, thus suggesting that it bears potential activity against hypertension. In addition, as the vessel segment can survive at least 4 hours after mounting and maintain contractility induced by the high-K+ solution for many times, we suggest that the wire myograph system may be used for the time-consuming process of drug screening.

The wire myograph technique is used to investigate vascular smooth muscle functions and screen new drugs. We report a detailed protocol for measuring the isometric contractility of the mouse mesenteric artery and for screening new relaxants of vascular smooth muscle.

Messung der isometrischen Kontraktilität der Maus mesenterialen Arterie mit Draht Myographie

The wire myograph technique is used to assess the contractility of vascular smooth muscles in response to depolarization, GPCR agonists/inhibitors and ...

A Cryoinjury Model to Study Myocardial Infarction in the Mouse

The use of animal models is essential for developing new therapeutic strategies for acute coronary syndrome and its complications. In this article, we demonstrate a murine cryoinjury infarct model that generates precise infarct sizes with high reproducibility and replicability. In brief, after intubation and sternotomy of the animal, the heart is lifted from the thorax. The probe of a handheld liquid nitrogen delivery system is applied onto the myocardial wall to induce cryoinjury. Impaired ventricular function and electrical conduction can be monitored with echocardiography or optical mapping. Transmural myocardial remodeling of the infarcted area is characterized by collagen deposition and loss of cardiomyocytes. Compared to other models (e.g., LAD-ligation), this model utilizes a handheld liquid nitrogen delivery system to generate more uniform infarct sizes.

This article demonstrates a model to study cardiac remodeling after myocardial cryoinjury in mice.

Ein Cryoinjury-Modell zur Untersuchung des Myokardinfarkts in der Maus

The use of animal models is essential for developing new therapeutic strategies for acute coronary syndrome and its complications. In this article, we ...

A Rabbit Venous Interposition Model Mimicking Revascularization Surgery using Vein Grafts to Assess Intimal Hyperplasia under Arterial Blood Pressure

Although vein grafts have been commonly used as autologous grafts in revascularization surgeries for ischemic diseases, the long-term patency remains poor because of the acceleration of intimal hyperplasia due to the exposure to arterial blood pressure. The present protocol is designed for the establishment of experimental venous intimal hyperplasia by interposing rabbit jugular veins to the ipsilateral carotid arteries. The protocol does not require surgical procedures deep in the body trunk and the extent of the incision is limited, which is less invasive for the animals, allowing long-term observation after implantation. This simple procedure enables researchers to investigate strategies to attenuate the progression of intimal hyperplasia of the implanted vein grafts. Using this protocol, we reported the effects transduction of microRNA-145 (miR-145), which is known to control the phenotype of vascular smooth muscle cells (VSMCs) from the proliferative to the contractile state, into harvested vein grafts. We confirmed the attenuation of intimal hyperplasia of vein grafts by transducing miR-145 before implantation surgery through the phenotype change of the VSMCs. Here we report a less invasive experimental platform to investigate the strategies that can be used to attenuate intimal hyperplasia of vein grafts in revascularization surgeries.

The present protocol aims to experimentally create venous intimal hyperplasia by subjecting veins to arterial blood pressure for developing strategies to attenuate venous intimal hyperplasia following revascularization surgery using vein grafts.

A Rabbit Venous Interposition Model Mimicking Revascularization Surgery using Vein Grafts to Assess Intimal Hyperplasia under Arteriellen Blutdruck

Although vein grafts have been commonly used as autologous grafts in revascularization surgeries for ischemic diseases, the long-term patency remains poor ...