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In This Article

  • Summary
  • Abstract
  • Introduction
  • Protocol
  • Representative Results
  • Discussion
  • Acknowledgements
  • Materials
  • References
  • Reprints and Permissions

Summary

The protocol presents a survival rodent model to test venoplasty balloon (VB) interventions in non-thrombotic, thrombotic, and post-thrombotic deep veins.

Abstract

Balloon venoplasty is a commonly used clinical technique to treat deep vein stenosis and occlusion as a consequence of trauma, congenital anatomic abnormalities, acute deep vein thrombosis (DVT), or stenting. Chronic deep venous obstruction is histopathologically characterized by thrombosis, fibrosis, or both. Currently, no direct treatment is available to target these pathological processes. Therefore, a reliable in vivo animal model to test novel interventions is necessary. The rodent survival inferior vena cava (IVC) venoplasty balloon model (VBM) allows the study of balloon venoplasty in non-thrombotic and post-thrombotic conditions across multiple time points. The local and systemic effect of coated and uncoated venoplasty balloons can be quantified via tissue, thrombus, and blood assays such as real-time polymerase chain reaction (RT-PCR), western blot, enzyme-linked immunosorbent assay (ELISA), zymography, vein wall and thrombus cellular analysis, whole blood and plasma assays, and histological analysis. The VBM is reproducible, replicates surgical human interventions, can identify local vein wall-thrombi protein changes, and allows multiple analyses from the same sample, decreasing the number of animals required per group.

Introduction

Deep vein obstructions from unresolved thrombi are a common consequence of deep vein thrombosis (DVT) and are one of the causes of post-thrombotic syndrome (PTS), costing billions of dollars in healthcare and significantly impacting the quality of life1,2,3. PTS is a unique inflammatory pathology with consequent vein wall fibrosis4 not fully captured in small animal DVT models5,6,7, and more importantly, previous models cannot evaluate the response to therapeu....

Protocol

The following protocol follows the University of Michigan (UMICH) Institutional Animal Care and Use Committee (IACUC) policies and guidelines, the U.S. Government Principles for the Utilization and Care of Vertebrate Animals Used in Testing, Research, and Training, and the ARRIVE guidelines 2.0. The UMICH Animal Welfare Assurance agreement is compliant with OLAW and USDA and is fully accredited by AAALAC International. This protocol was approved with the ID number PRO00010841. Male outbred Sprague Dawley rats from Charle.......

Representative Results

The VBM is a model that evaluates the effect of venoplasty balloons in complete hemostasis control. First, we quantified the IVC (mid-infrarenal section) diameter, as shown in Figure 1, for correct balloon sizing. Second, the developed step-by-step microsurgical technique is illustrated in Figure 2, and we also show examples of the critical steps in Figure 3. Notice the retrograde approach used for the IVC canulation with the sharpe.......

Discussion

The VBM can be performed on rats ≥ 250 g using balloons in the 2.5-3.5 mm range. For rats exceeding 750 g, the technique is limited by a higher amount of adipose tissue in the abdominal cavity and organ size rather than changes in IVC diameter. From our experience, we have found that 10 or more animals per group are needed to obtain statistical significance between the groups for vein wall protein analysis or activity assays and histology. Periodic temperature control and respiration rate surveillance during surgic.......

Acknowledgements

This study is supported by the American Venous Forum (AVF) 2023 Basic Science research grant and Surmodics, Inc.

....

Materials

NameCompanyCatalog NumberComments
3-0 DemeCRYLDemeTechG183019F4P12 per box
5-0 DemeCRYLDemeTechG285017B0P12 per box
7-0 DemeLENEDemeTechPM197011F13M12 per box
8-0 DemeLONDemeTechNL868007C7P12 per box
Angled Clip ApplierSCANLAN3795-01A7-1/4″ (18.5 cm)
Baxter 0.9% Sodium Chloride Irrigation BottleBaxterSKU: 195-71241000mL Bottle
Bovie Cautery Low Temperature Fine TipSymmetry Surgical IncAA0010/bx
BuprenorphineFidelis Animal HealthSKU- 0991141.3mg/mL, 3mL
CD (Sprague Dawley) RatsCharles RiverStrain Code 001Male, 400 gm
Clip-It Traceable TimerTRACEABLE PRODUCTSCat. No. 5046
Cotton-Tip Applicator 3"Dukal Corporation922-00037BX1001000/BOX
Enzymatic Surgical Instrument Detergent and PresoakMedlineMDS88000B91 Gal
Eye LubeOptixcareSKU-06544120gm 
Gaymar T/Pump Stryker Localized Warming/Cooling Therapy SystemStrykerTP700
Heifetz Microclips 12mmx2.25mmSCANLAN3795-20Straight
Heifetz Microclips 12mmx2.25mmSCANLAN3795-28Curved
Heifetz Microclips 8mmx1.75mm SCANLAN3795-14Straight
Heifetz Microclips 8mmx1.75mm SCANLAN3795-18Curved
Inflation device Merit MedicalIN4130BasixCOMPAK with Analog Display
IsofluraneMFR VETONESKU-501017100mL, Liquid for Inhalation
Microsurgery kit containing tweezers and forcepsCustomized
Oxygen, E-tankMedlineMDM1630
Sharpened GuidewireCustomized
Sterile Glad Press-n-SealGladSKU # PSS-140ETO Exposed
Sterile Nonwoven Gauze Sponges 2s 4ply 4x4 MedlineSKU PRM21444H100Ct
Surgical microscope ZeissS100 / OPMI pico
Surgical Scrub & HandwashVetoquinolNDC: 17030-003-1616 oz
Ultrasound GelMedlineCTR0013058.5 oz, 12/CS
Ultrasound systemSiemensACUSON Antares3-D, Color, Continuous wave (CW), Pulsed wave (PW), Power CW/CW Spectral
Venoplasty BalloonCustomized

References

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