Name: myocardial infarction by percutaneous embolization coil deployment in a swine model
Uploaded: 2021-11-04T13:00:00
Description: Watch this Scientific Journal Video about Myocardial Infarction by Percutaneous Embolization Coil Deployment in a Swine Model at JoVE.com

We express our gratitude to the Center of Comparative Medicine and Bioimaging of Catalonia (CMCiB) and staff for their contribution to the animal model execution. This work was supported by the Instituto de Salud Carlos III (PI18/01227, PI18/00256, INT20/00052), the Sociedad Espa&#241;ola de Cardiolog&#237;a, and the Generalitat de Catalunya [2017-SGR-483]. This work was also funded by the Red de Terapia Celular - TerCel [RD16/0011/0006] and CIBER Cardiovascular [CB16/11/00403] projects, as part of the Plan Nacional de I+D+I, and cofunded by the ISCIII-Subdirecci&#243;n General de Evaluaci&#243;n y el Fondo Europeo de Desarrollo Regional (FEDER). Dr. Fadeuilhe was supported by a grant from the Spanish Society of Cardiology (Madrid, Spain).

This study was approved by the Animal Experimentation Unit Ethical Committee of the Germans Trias i Pujol Health Research Institute (IGTP) and Government Authorities (Generalitat de Catalunya; Code: 10558 and 11208), and complies with all guidelines concerning the use of animals in research and teaching as defined by the Guide for the Care and Use of Laboratory Animals25.
1.&#65279; Preprocedural preparation of animals
<ol>
	<li>Use crossbred Landrace...

<ol>
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Cardiovascular Imaging. 4 (1), 98-108 (2011).</li><li>Srikanth, G., Prakash, P., Tripathy, N., Dikshit, M., Nityanand, S. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Establishment+of+a+rat+model+of+myocardial+infarction+with+a+high+survival+rate:+A+suitable+model+for+evaluation+of+efficacy+of+stem+cell+therapy.">Establishment of a rat model of myocardial infarction with a high survival rate: A suitable model for evaluation of efficacy of stem cell therapy.</a> Journal of Stem Cells and Regenerative Medicine. 5 (1), 30 (2009).</li><li>Wu, Y., Yin, X., Wijaya, C., Huang, M. -. H., McConnell, B. K. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Acute+myocardial+infarction+in+rats.">Acute myocardial infarction in rats.</a> Journal of Visualized Experiments: JoVE. 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C., Post, M., Simons, M., Annex, B. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Translational+physiology:+porcine+models+of+human+coronary+artery+disease:+implications+for+pre-clinical+trials+of+therapeutic+angiogenesis.">Translational physiology: porcine models of human coronary artery disease: implications for pre-clinical trials of therapeutic angiogenesis.</a> Journal of Applied Physiology. 94 (5), 1689-1701 (2003).</li><li>Tsang, H. G., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Large+animal+models+of+cardiovascular+disease.">Large animal models of cardiovascular disease.</a> Cell Biochemistry and Function. 34 (3), 113 (2016).</li><li>Dixon, J. A., Spinale, F. G. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Large+animal+models+of+heart+failure.">Large animal models of heart failure.</a> Circulation: Heart Failure. 2 (3), 262-271 (2009).</li><li>G&#225;lvez-Mont&#243;n, C., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Transposition+of+a+pericardial-derived+vascular+adipose+flap+for+myocardial+salvage+after+infarct.">Transposition of a pericardial-derived vascular adipose flap for myocardial salvage after infarct.</a> Cardiovascular Research. 91 (4), 659-667 (2011).</li><li>G&#225;lvez-Mont&#243;n, C., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Comparison+of+two+pre-clinical+myocardial+infarct+models:+coronary+coil+deployment+versus+surgical+ligation.">Comparison of two pre-clinical myocardial infarct models: coronary coil deployment versus surgical ligation.</a> Journal of Translational Medicine. 12, 137 (2014).</li><li>Domkowski, P. W., Hughes, G. C., Lowe, J. E. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Ameroid+constrictor+versus+hydraulic+occluder:+creation+of+hibernating+myocardium.">Ameroid constrictor versus hydraulic occluder: creation of hibernating myocardium.</a> The Annals of Thoracic Surgery. 69 (6), 1984 (2000).</li><li>Tuzun, E., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Correlation+of+ischemic+area+and+coronary+flow+with+ameroid+size+in+a+porcine+model.">Correlation of ischemic area and coronary flow with ameroid size in a porcine model.</a> Journal of Surgical Research. 164 (1), 38-42 (2010).</li><li>Weism&#252;ller, P., Mayer, U., Richter, P., Heieck, F., Kochs, M., Hombach, V. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Chemical+ablation+by+subendocardial+injection+of+ethanol+via+catheter+-+preliminary+results+in+the+pig+heart.">Chemical ablation by subendocardial injection of ethanol via catheter - preliminary results in the pig heart.</a> European Heart Journal. 12 (11), 1234-1239 (1991).</li><li>Haines, D., Verow, A., Sinusas, A., Whayne, J., DiMarco, J. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Intracoronary+ethanol+ablation+in+swine:+characterization+of+myocardial+injury+in+target+and+remote+vascular+beds.">Intracoronary ethanol ablation in swine: characterization of myocardial injury in target and remote vascular beds.</a> Journal of Cardiovascular Electrophysiology. 5 (1), 41-49 (1994).</li><li>Li, K., Wagner, L., Moctezuma-Ramirez, A., Vela, D., Perin, E. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=A+robust+percutaneous+myocardial+infarction+model+in+pigs+and+its+effect+on+left+ventricular+function.">A robust percutaneous myocardial infarction model in pigs and its effect on left ventricular function.</a> Journal of Cardiovascular Translational Research. , (2021).</li><li>Eldar, M., Ohad, D., Bor, A., Varda-Bloom, N., Swanson, D., Battler, A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=A+closed-chest+pig+model+of+sustained+ventricular+tachycardia.">A closed-chest pig model of sustained ventricular tachycardia.</a> Pacing and Clinical Electrophysiology : PACE. 17 (10), 1603-1609 (1994).</li><li>Dib, N., Diethrich, E. B., Campbell, A., Gahremanpour, A., McGarry, M., Opie, S. 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(86), e51269 (2014).</li><li>Kumar, M., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Animal+models+of+myocardial+infarction:+Mainstay+in+clinical+translation.">Animal models of myocardial infarction: Mainstay in clinical translation.</a> Regulatory Toxicology And Pharmacology RTP. 76, 221-230 (2016).</li></ol>

A coil deployed in a coronary artery provides a reproducible and consistent pre-clinical non-reperfused MI model in swine that can be used to develop and test new cardiovascular therapeutic strategies.
In our hands, mortality at follow-up was 19% related to complications of MI, mostly within the first 24 h of the procedure. All these deaths are related to the natural history of the non-reperfused MI and were the primary outcomes of the study. One of the most critical steps in this protocol rel...

An erratum was issued for:&#160;<a href="https://www.jove.com/t/63172">Myocardial Infarction by Percutaneous Embolization Coil Deployment in a Swine Model</a>. The Protocol and Discussion sections were updated.
Step 3.5 was updated from:
Clean the right femoral area with surgical soap and antiseptic povidone-iodine solution under sterile conditions
to:
Clean the right femoral area with surgical soap followed by alternating antiseptic povidone-iodine solution and alcohol 3 times under sterile conditions.
Section 9 was updated from:
9. Euthanasia method
<ol>
	<li>Under previous sedation and anesthesia, as previously described, administer an IV sodium thiopental overdose (200 mg/kg).</li>
	<li>Confirm cardiorespiratory arrest and death by monitoring vital signs (electrocardiogram, blood pressure, capnography).</li>
</ol>
to:
9. Postoperative pain assessment and monitoring
<ol>
	<li class="jove_content">During the post-surgical follow-up, monitor the general condition of the animals, including the respiratory rate, food and water intake, activity and interaction with the other individuals, appearance and coloration of the skin, and the evolution of the surgical wound.</li>
	<li class="jove_content">Apply a daily supervision protocol according to the following scoring criteria: 
	- Weight: 
	0: Normal 
	1: &#60;10% weight loss 
	2: 10-20% weight loss 
	3:&#62; 20% weight loss 
	 
	- Body condition: 
	0: Good: non-prominent vertebrae, pelvic or spinal bones 
	2: Regular: evidence of spinal segmentation, palpable pelvic bones 
	3: Emaciation: extremely marked skeleton, little or no meat to cover 
	 
	- Behavior: 
	0: Normal: Active and interactive in your environment 
	1: Slight decline in activity and less interactive 
	2: Abnormal: pronounced decline in activity, isolated 
	3: Abnormal: Immobile or hyperactivity, possible self-harm 
	 
	- Physical appearance: 
	0: Normal: skin/hair shiny and eyes bright 
	1: Disappears embalming, skin/hair without shine 
	2: Poor skin/nasal secretions 
	3: Poor skin, abnormal or hunched posture 
	 
	- Behavioral disorders: 
	0: None 
	1: Inability to move normally 
	2: Unable to reach food/drink, isolated from other animals 
	3: Intention to hide/corner, does not respond to stimuli (dying) 
	 
	- Clinical signs: 
	0: None 
	1: Hypothermia, fever, mild respiratory failure 
	2: Infection of the surgical wound, moderate respiratory failure with muco-bloody secretions 
	3: Heart failure, severe respiratory failure (cyanosis, open mouth) 
	 
	Score: 
	- 1-5: Supervise the animals once a day. 
	- 6-12: Provide supportive therapy if necessary. 
	- Any animal with a score of 3 in any of the above parameters or with a total score &#62;12 will be euthanized. 
	NOTE: The animals should be monitored daily by the animal care staff and twice a week by the research and veterinary team.</li>
	<li class="jove_content">Although no pain and distress are expected from the procedure, if any animal shows signs of pain, give analgesic therapy (tramadol, oral, 2-4 mg/kg, daily). If any animal does not respond to analgesic medication and shows signs of chronic pain (very low probability), euthanize the animal with an anesthetic overdose (sodium thiopental, IV, 200 mg/kg).</li>
	<li class="jove_content">If the surgical wound shows signs of infection (low probability) despite the antibiotic therapy administered, treat the wound daily and initiate a new antibiotic regimen (cefquinome sulphate, IM, 2 mg/kg, daily).</li>
</ol>
10. Euthanasia method
<ol>
	<li>Under previous sedation and anesthesia, as previously described, administer an IV sodium thiopental overdose (200 mg/kg).</li>
	<li>Confirm cardiorespiratory arrest and death by monitoring vital signs (electrocardiogram, blood pressure, capnography).</li>
</ol>

An erratum was issued for:&#160;<a href="https://www.jove.com/t/63172">Myocardial Infarction by Percutaneous Embolization Coil Deployment in a Swine Model</a>. The Protocol and Discussion sections were updated.

Erratum: Myocardial Infarction by Percutaneous Embolization Coil Deployment in a Swine Model

Myocardial infarction (MI) is the most prevalent cause of mortality, morbidity, and disability worldwide1. Despite current therapeutic advances, a significant proportion of patients develop adverse ventricular remodeling and progressive heart failure following MI, resulting in poor prognosis due to ventricular dysfunction and sudden death2,3,4. New therapeutic options to repair and/or regenerate injured myocardium are thus under scrutiny, and translational MI animal models are crucial in testing their safety and efficacy. Although several models have been used for cardiovascular research, including rats5,6, mice7,8, dogs9, and sheep10, pigs are one of the best choices for modeling cardiac ischemia studies because of their high similarity to humans in terms of heart size, coronary artery anatomy, cardiac kinetics, physiology, metabolism, and the post-MI healing process11,12,13,14,15.
In this context, many different open-surgical and percutaneous approaches are available to develop MI swine models. The open-chest approach involves a left lateral thoracotomy procedure and is useful in performing surgical coronary artery ligation16,17, myocardial cryo-injury, cauterization12, and coronary artery placement of a hydraulic occlude18 or an ameroid constrictor19, among others. Surgical coronary occlusion has been extensively used to test new therapeutic options such as cardiac tissue engineering and cell therapy, as it allows wide access and visual assessment of the heart; however, in contrast to human MI, it can result in surgical adhesions, adjacent scarring, and postoperative inflammation17. Myocardial cryo-injury and cauterization are easily reproducible techniques but do not reproduce the pathophysiological MI progression observed in humans12. On the other hand, several percutaneous techniques have been developed to produce temporary or permanent coronary blocking. These comprise transcoronary or intracoronary ethanol ablation20,21, occlusion by balloon angioplasty22, or delivery of thrombogenic materials such as agarose gel beads23, fibrinogen mixtures9, or coil embolization17,24. While balloon angioplasty is better suited for ischemia/reperfusion studies, coronary coil deployment is one of the best choices for modeling non-revascularized MI. This percutaneous approach is feasible, consistently reproducible, and avoids open-chest surgery. It allows precise control of the infarct location and results in pathophysiology similar to that of a human non-reperfused MI. Moreover, coil embolization is suitable for modeling acute, sub-acute, or chronic MI; chronic congestive heart failure; or valvular disease17.
The present protocol aims to describe how to develop an MI swine model by permanent coil deployment. Briefly, it comprises a percutaneous selective coronary artery cannulation through retrograde femoral access. Following coronary angiography, a coil is deployed at the target branch artery under fluoroscopic guidance. Finally, complete occlusion is confirmed by repeated coronary angiography.

<table border="1" fo:keep-together.within-page="1" fo:keep-with-next.within-page="always">
	<tbody>
		<tr>
			<td>6-F JR4 0-71&#34;guiding catheter</td>
			<td>Medtronic</td>
			<td>LA6JR40</td>
			<td>6F JR4 90 cm Guiding catheter</td>
		</tr>
		<tr>
			<td>Adrenaline 1 mg/mL</td>
			<td>B.Braun</td>
			<td>National Code (NC). 602486</td>
			<td>Adrenaline</td>
		</tr>
		<tr>
			<td>Atropine 1 mg/mL</td>
			<td>B.Braun</td>
			<td>NC. 635649</td>
			<td>Atropine</td>
		</tr>
		<tr>
			<td>Betadine</td>
			<td>Mylan</td>
			<td>NC. 694109-1</td>
			<td>Povidone iodine solution</td>
		</tr>
		<tr>
			<td>Bupaq 0.3 mg/mL</td>
			<td>Richter Pharma AG</td>
			<td>NC. 578816.6</td>
			<td>Buprenorphine</td>
		</tr>
		<tr>
			<td>Dexdomitor 0.5 mg/mL</td>
			<td>Orion Pharma</td>
			<td>NC. 576303.3</td>
			<td>Dexmedetomidine</td>
		</tr>
		<tr>
			<td>Draxxin</td>
			<td>Zoetis</td>
			<td>NC. 576313.2</td>
			<td>Tulathromycin</td>
		</tr>
		<tr>
			<td>EMERALD Guidewire</td>
			<td>Cordis</td>
			<td>502-585</td>
			<td>0.035-inch J-tipped wire</td>
		</tr>
		<tr>
			<td>External defibrillator</td>
			<td>DigiCare</td>
			<td>CS81XVET</td>
			<td>Manual external defibrillator</td>
		</tr>
		<tr>
			<td>Fendivia 100 &#181;g/h</td>
			<td>Takeda</td>
			<td>NC. 658524.5</td>
			<td>Fentanyl transdermal patch</td>
		</tr>
		<tr>
			<td>Guidewire Introducer Needle 18 G x 7 cm</td>
			<td>Argon</td>
			<td>GWI1802</td>
			<td>Introducer needle</td>
		</tr>
		<tr>
			<td>Heparine 1%</td>
			<td>ROVI</td>
			<td>NC. 641647.1</td>
			<td>Heparin</td>
		</tr>
		<tr>
			<td>Hi-Torque VersaTurn F</td>
			<td>Abbott</td>
			<td>1013317J</td>
			<td>0.014-inch 200 cm Guidewire</td>
		</tr>
		<tr>
			<td>IsoFlo</td>
			<td>Zoetis</td>
			<td>50019100</td>
			<td>Isoflurane</td>
		</tr>
		<tr>
			<td>Ketamidor</td>
			<td>Richter Pharma AG,</td>
			<td>NC. 580393.7</td>
			<td>Ketamine</td>
		</tr>
		<tr>
			<td>Lidocaine 50 mg/mL</td>
			<td>B.Braun</td>
			<td>NC. 645572.2</td>
			<td>Lidocaine</td>
		</tr>
		<tr>
			<td>MD8000vet</td>
			<td>Meditech Equipment</td>
			<td>MD8000vet</td>
			<td>Multi-parameter monitor</td>
		</tr>
		<tr>
			<td>Midazolam</td>
			<td>Laboratorios Normon</td>
			<td>NC. 624437.1</td>
			<td>Midazolam</td>
		</tr>
		<tr>
			<td>Prelude.6F.11 cm (4.3&#34;).0.035&#34; (0.89 mm).50 cm (19.7&#34;).Double Ended.Stainless Steel.6F.16</td>
			<td>Merit</td>
			<td>PSI-6F-11-035</td>
			<td>6F Vascular sheath</td>
		</tr>
		<tr>
			<td>Propovet Multidosis 10 mg/mL</td>
			<td>Zoetis</td>
			<td>NC. 579742.7</td>
			<td>Propofol</td>
		</tr>
		<tr>
			<td>RENEGADE STC-18 150/20/STRAIGHT/1RO</td>
			<td>Boston Scientific</td>
			<td>M001181370</td>
			<td>150 cm length with 0.017-inch inner diameter Microcatheter</td>
		</tr>
		<tr>
			<td>Ruschelit</td>
			<td>Teleflex</td>
			<td>112482</td>
			<td>Endotracheal tube with balloon (#6.5)</td>
		</tr>
		<tr>
			<td>SPUR II</td>
			<td>Ambu</td>
			<td>325 012 000</td>
			<td>Airway mask bag unit-ventilation (AMBU)</td>
		</tr>
		<tr>
			<td>Vasofix 20 G</td>
			<td>B.Braun</td>
			<td>4269098</td>
			<td>20 G Cannula</td>
		</tr>
		<tr>
			<td>Visipaque 320 mg/mL USB 10 x 200 mL</td>
			<td>General Electrics</td>
			<td>1177612</td>
			<td>Iodinated contrast medium</td>
		</tr>
		<tr>
			<td>VortX-18 Diamond 3 mm/3.3 mm</td>
			<td>Boston Scientific</td>
			<td>M0013822030</td>
			<td>Coil</td>
		</tr>
		<tr>
			<td>WATO EX-35</td>
			<td>Mindray</td>
			<td>WATO EX-35Vet</td>
			<td>Anesthesia machine</td>
		</tr>
	</tbody>
</table>

myocardial infarction by percutaneous embolization coil deployment in a swine model

Myocardial infarction (MI) is the leading cause of mortality worldwide. Despite the use of evidence-based treatments, including coronary revascularization and cardiovascular drugs, a significant proportion of patients develop pathological left-ventricular remodeling and progressive heart failure following MI. Therefore, new therapeutic options, such as cellular and gene therapies, among others, have been developed to repair and regenerate injured myocardium. In this context, animal models of MI are crucial in exploring the safety and efficacy of these experimental therapies before clinical translation. Large animal models such as swine are preferred over smaller ones due to the high similarity of swine and human hearts in terms of coronary artery anatomy, cardiac kinetics, and the post-MI healing process. Here, we aimed to describe an MI model in pig by permanent coil deployment. Briefly, it comprises a percutaneous selective coronary artery cannulation through retrograde femoral access. Following coronary angiography, the coil is deployed at the target branch under fluoroscopic guidance. Finally, complete occlusion is confirmed by repeated coronary angiography. This approach is feasible, highly reproducible, and emulates the pathogenesis of human non-revascularized MI, avoiding the traditional open-chest surgery and the subsequent postoperative inflammation. Depending on the time of follow-up, the technique is suitable for acute, sub-acute, or chronic MI models.

MI survival rates and location 
Fifty-seven pigs underwent coronary coil implantation in the LCX marginal branch (n = 25; 12 females and 13 males) or in the LAD between the first and the second diagonal branches (n = 32; 16 females and 16 males) of the coronary artery and were followed up for 30 days. The survival rate of animals submitted to an MI at the LCX marginal branch was 80% (n = 20). Three pigs died as a result of fatal complications related to atrioventricular (AV) block and asystole befor...

Watch this Scientific Journal Video about Myocardial Infarction by Percutaneous Embolization Coil Deployment in a Swine Model at JoVE.com

Myocardial Infarction by Percutaneous Embolization Coil Deployment in a Swine Model

Myocardial infarction (MI) animal models that emulate the natural process of the disease in humans are crucial to understanding pathophysiological mechanisms and testing the safety and efficacy of new emergent therapies. Here, we describe an MI swine model created by deploying a percutaneous embolization coil.

Myocardial infarction (MI) is the leading cause of mortality worldwide. Despite the use of evidence-based treatments, including coronary revascularization ...

This protocol is important because it allows performing myocardial infarction in a translational animal model, in a feasible and reproducible way similar to human. The main advantage of this procedure is that it avoids the traditional open-chest surgery and the subsequent postoperative inflammation. And therefore is one of the best choices mimicking human myocardial infarction.This technique is suitable for modeling myocardial infarction and higher failure depending on the dissection of the ischemic area. Begin by placing the anesthetized animal on the operating table in the supine position and fix the limbs to the table with tape or bandage. Place the electrocardiogram probes subcutaneously in the animals'extremities for recording changes in the ST-segment, T-waves and heart rate during the experimental procedure.Place the pulse oximeter on the tongue or a corner of the animal's lip and the non-invasive pressure cuff on the for limb. Measure the temperature with a esophageal probe. Clean the right femoral area with surgical soap followed by alternating antiseptic povidone-iodine solution and alcohol three times under sterile conditions.Wash the hands surgically and wear sterile gown and sterile gloves. Then cover the animal with a sterile surgical drape. Flush the needle vascular sheath J-tipped wire, guiding catheter, guidewire microcatheter, and the contrast medium injection manifold kit with heparinized saline solution.Locate the bifurcation between the superficial and deep femoral arteries using ultrasound. Position the transducer two to three centimeters proximal to the bifurcation in the common femoral artery and align the center of the transducer with the common femoral artery. Now position the needle in the center of the transducer and puncture the artery at angulation of approximately 45 degrees.Subsequently, insert a six French vascular sheath using the modified Seldinger technique and administer heparin through the sheath. Begin by inserting the J-tip wire into the JR4r guide catheter and advance the wire through the sheath into the ascending aorta. Place the catheter up over the valvular surface.After removing the wire connect the catheter to the injection manifold system and purge the entire system. Under fluoroscopy, engage the catheter into the left main coronary artery and inject 10 milliliters of iodinated contrast medium to visualize the left coronary system. Perform angiograms in the left anterior oblique 40 degrees and right anterior oblique 30 degrees projections.Under fluoroscopic guidance, advance 0.014-inch guidewire pre-assembled on the microcatheter to the middle left anterior descending or distal left circumflex coronary artery. Under fluoroscopic guidance, advance the microcatheter through the wire to the desired location where the coil implant should be deployed. Remove the wire and select the coil.Deliver the coil via microcatheter and slowly inject five milliliters of iodinated contrast medium under fluoroscopy to visualize the correct position of the coil. Place the wire in a side branch to perform control injections and to ensure access to the artery if a second coil needs to be implanted. Wait for the coil to thrombose and occlude the artery.57 pigs underwent coronary coil implantation and their angiographic showed myocardial infarction in the distal left circumflex marginal branch or distal left anterior descending coronary artery. The mortality of this model was 19%related to complications of MI.Magnetic resonance imaging analysis of the left circumflex marginal branch and distal left anterior descending coronary infarctions was performed in all animals 30 days post myocardial infarction. The coil deployment in the left circumflex marginal coronary artery affected the left ventricular lateral wall.While the intra-ventricular septum is the most affected area in distal left anterior descending coronary placement. The infarcted areas post coil development in the left circumflex marginal coronary artery and the distal left anterior descending coronary were also confirmed after heart sectioning. The most important steps include, first, to place the microcatheter in the right position.Second, to choose the correct coil size and third to deliver it properly. Thanks to this model, researchers can explore new therapies and study the pathophysiological mechanism of myocardial infarction.

Research

JoVE Journal

Medicine

Acute Myocardial Infarction in Rats

With heart failure leading the cause of death in the USA (Hunt), biomedical research is fundamental to advance medical treatments for cardiovascular ...

Myocardial Infarction and Functional Outcome Assessment in Pigs

Introduction of newly discovered cardiovascular therapeutics into first-in-man trials depends on a strictly regulated ethical and legal roadmap. One ...

A Hydrogel Construct and Fibrin-based Glue Approach to Deliver Therapeutics in a Murine Myocardial Infarction Model.

The murine MI model is widely recognized in the field of cardiovascular disease, and has consistently been used as a first step to test the efficacy of ...

Primary Outcome Assessment in a Pig Model of Acute Myocardial Infarction

Mortality after acute myocardial infarction remains substantial and is associated with significant morbidity, like heart failure. Novel therapeutics are ...

Myocardial Infarction in Neonatal Mice, A Model of Cardiac Regeneration

Myocardial infarction induced by coronary artery ligation has been used in many animal models as a tool to study the mechanisms of cardiac repair and ...

Improvement of a Closed Chest Porcine Myocardial Infarction Model by Standardization of Tissue and Blood Sampling Procedures

Myocardial ischemia reperfusion (I/R) injury contributes to almost half of the necrotic area after myocardial infarction. To date there is no approved ...

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 ...

Establishing a Swine Model of Post-myocardial Infarction Heart Failure for Stem Cell Treatment

Although advances have been achieved in the treatment of heart failure (HF) following myocardial infarction (MI), HF following MI remains one of the major ...

Novel Percutaneous Approach for Deployment of 3D Printed Coronary Stenosis Implants in Swine Models of Ischemic Heart Disease

Minimally invasive methods for creating models of focal coronary narrowing in large animals are challenging. Rapid prototyping using three-dimensionally ...

Intramyocardial Transplantation of MSC-Loading Injectable Hydrogels after Myocardial Infarction in a Murine Model

One of the major issues facing current cardiac stem cell therapies for preventing postinfarct heart failure is the low retention and survival rates of ...