안젤라 프룬드 부인에게 임베드 및 슬라이드 생산에 대한 귀중한 기술 적 지원에 감사드립니다. 우리는 또한 수의학 작업에 대한 그의 통찰력있는 도움에 대한 실험실 동물 과학 및 실험 수술 연구소에서 씨 Tadeusz Stopinski에게 감사드립니다.

이 실험은 과학적 목적으로 사용되는 동물의 보호와 관련된 독일 동물 복지법(TSchG) 및 지침 2010/63/EU에 따라 수행되었습니다. 이 연구에 대한 공식 승인은 정부 동물 관리 및 사용위원회에 의해 부여되었다 (의정서 번호: AZ 87-51.04.2010.A065; 란데삼트 퓌르 나투르, 움웰트 und 베르브라우체슈츠 노르드하인-웨스트팔렌, 레클링하우젠, 독일). 연구 프로토콜은 실험실 동물의 치료 및 사용을위한 가이드를 준수. 수술 후 통증 치료는 실험실 동물 과학에 대한 독일 사회의 권고에 따라 (GV-SOLAS) 뿐만 아니라 이니셔티브 수의 통증 치료.
1. 기본 기술과 일반적인 절차
<ol><li>동형 어 아포를 사용-/- 스프라그-Dawley 쥐. 표준방법(17)을사용하여 각 동물의 유전자형을 식별한다.</li>
	<li>동일한 조건(21°C ± 2°C, 습도 5% ± 60%, 12h 빛/암흑 주기)에서 동물을 유지하고 물과 음식에 대한 자유로운 접근을 보장합니다.</li>
	<li>깨끗하지만 비살균 조건에서 모든 절차를 수행하십시오.</li>
	<li>쥐가 마취되면, 16x의 배율에서 외과 현미경의 밑에 모든 절차를 수행하십시오.</li>
	<li>압축 hemostasis에 면 봉면을 사용합니다. 수유링거 용액에 담근 거즈 면봉(5cm x 5cm)은 사타구니를 촉촉하게 유지하는 데 도움이 됩니다.</li>
	<li>폐기물 처리 규정을 준수하여 중고 자재를 폐기하십시오.</li>
</ol>2. 수술 전 준비
<ol><li>수술을 시작하기 전에 수의학 약물을 준비합니다. 달리 명시되지 않는 한 모든 솔루션을 실온에서 유지하십시오.</li>
	<li>
시술 30분 전에 0.03-0.05 mg/kg 부프레노르핀을 피하한다.
</li>
	<li>쥐의 내회음 주사로 쥐를 마취 100 mg/kg 체중 (BW) (S)-케타민과 8 mg/kg BW 자일라진.</li>
	<li>계량 스케일을 사용하여 쥐의 무게를 평가합니다.</li>
	<li>가열 패드에 쥐를 놓고 의료 테이프를 사용하여 상체와 하반신을 고정합니다. 쥐를 왼쪽 뒷다리로 완전히 확장하고 가능한 한 척추에 맞춰 쥐를 배치하여 대퇴동맥과 대동맥 사이의 직선선을 만듭니다. 이렇게 하면 대동맥 분기를 통해 풍선 장착 스텐트를 진행할 수 있습니다.</li>
	<li>2 L/min의 유량으로 97.5%의 산소로 1.5vol% 이소플루란을 흡입하여 마취를 유지한다. 참고: 쥐가 삽관 없이 자발적으로 호흡하도록 허용합니다.</li>
	<li>무의식 시 눈 손상을 방지하기 위해 눈 연고를 적용하십시오.</li>
	<li>쥐의 사타구니와 하복부 부위에서 털을 면도하고 포비도네 요오드 용액으로 해당 피부를 살균합니다.</li>
	<li>수술을 시작하기 전에 꼬리 끝과 디지털 간 조직을 꼬집어 마취의 적절한 깊이를 확인하십시오.</li>
</ol>3. 수술
<ol><li>피부와 기본 근막을 열기 위해 왼쪽 사타구니에 ~ 0.5\u20121 cm의 내향 절개를 합니다.</li>
	<li>맥동 왼쪽 대퇴 동맥이 식별 될 때까지 무뚝뚝하게 해부하고 깊이에서 프로브.</li>
	<li>매우 미세한 집게를 사용하여 주변 결합 조직을 부드럽게 제거하여 대퇴동맥을 준비합니다. 대퇴신경이나 대퇴정맥을 해칠 수 있도록 주의하십시오.</li>
	<li>대퇴동맥 약 1cm를 준비한다. 조심스럽게 부드럽게 들어 올리기 위해 용기 아래에 집게의 끝을 넣어.</li>
	<li>동맥의 단부 및 근근 부분 하에서 4-0 실크 봉합사의 실 조각과 포새를 형성합니다. 수술 클램프의 가지 사이에 두 개의 실 새총의 끝을 고정합니다. 동맥을 제어하기 위해 수술 클램프를 사용합니다. 일시적으로 혈류를 방해하기 위해 슬링을 부드럽게 스트레칭하고 들어 올립니다. 참고: 조직 손상으로 이어질 수 있는 장기간 지혈대를 피하기 위해 빨리 작업하십시오.</li>
	<li>날카로운 마이크로 가위를 사용하여 대퇴 동맥 한가운데에서 동맥 절제술을 수행합니다.</li>
	<li>동맥 절제술을 통해 가이드 와이어를 소개합니다. 근위실 새슬링에 도달하면 수술용 클램프를 이동하여 실의 장력을 방출하고 가이드 와이어를 복부 대어로 더 발전시보를 진행합니다. 참고: 와이어 커터를 사용하여 가이드 와이어를 잘라 처리를 용이하게 합니다.</li>
	<li>다이어프램과 신장 동맥 사이에 가이드 와이어의 근접 끝을 놓습니다. 참고: 가이드 와이어를 너무 멀리 진행하려면 대동맥 이나 심장 손상의 위험이 있습니다. 가이드 와이어와 스텐트의 적절한 위치를 보장하기 위해 복부를 여는 것이 좋습니다.</li>
	<li>가이드 와이어를 통해 2.25mm x 8mm(최대 2.5mm x 8mm)의 압착 및 풍선 장착 관상 동맥 스텐트를 대퇴동맥으로 전환하여 복부 대동맥으로 진행합니다.</li>
	<li>스텐트를 대동맥 분면 바로 위에 놓지만 신장 동맥 아래에 놓습니다. 팽창 주사기 시스템을 사용하여 풍선 카테터를 12 atm에 15s로 팽창시켜 스텐트를 배치합니다.</li>
	<li>풍선 카테터를 수축하고 사용 중 스텐트에 대한 제조업체의 권장 사항에 따라 음의 압력을 유지합니다.</li>
	<li>스텐트를 제자리에 두면서 수축된 카테터를 천천히 철회합니다.</li>
	<li>카테터를 꺼내기 직전에 수술 용 클램프로 절개 위의 스레드 루프에 긴장을 만들어 혈류를 다시 방해합니다. 그런 다음 풍선 카테터를 제거하고 직접 선박을 근교로 리게이트합니다.</li>
	<li>근위와 말단 실 루프를 묶어 대퇴동맥을 리로하고 동맥 절제술의 적절한 혈청을 확인합니다. 부수적 인 동맥은 사지에 더 관류를 보장합니다.</li>
	<li>10-0 비 반향 봉합사를 사용하여 동맥과 피부 절개를 과도하게 근육으로 닫습니다.</li>
</ol>4. 스텐트 이식 후 동물 관리
<ol><li>수술 직후, 쥐는 따뜻한 공기 (30\u201235 °C)와 산소 공급과 특수 중환자 실 케이지에서 60 분 동안 회복 할 수 있습니다.</li>
	<li>완전히 회복 될 때까지 동물을주의 깊게 관찰하십시오. 그 후, 쥐를 일반 케이지로 옮킨다. 물과 음식에 대한 광고 리비도 액세스를 제공합니다.</li>
	<li>수술 후 진통을 0.03-0.05 mg/kg 부프레노르핀(s.c., 500μl NaCl에서 임상 평가하에서 총 72시간 동안 투여한다.</li>
	<li>이식된 스텐트의 혈전증을 피하기 위해 클로피도그렐(15 mg/kg)과 혼합된 식품을 먹습니다.</li>
	<li>콜레스테롤 과 플라크 형성을 강화하려면 출생 후 6 \u20128 주에서 서양 식단 을 시작하고 안락사 까지 계속하십시오. 원하는 경우, 일반 쥐 차우를 먹이동물의 집단은 제어 역할을 할 수 있습니다.</li>
</ol>5. 조직 수집 및 처리
<ol><li>지정된 시점에서 조직을 시작하기 전에 IACUC 지침에 따라 동물을 안락사시하십시오. 관찰 기간이 끝날 때 조직학적 분석을 위해 스텐트 대어타를 수확한다.</li>
	<li>중간선 절개에 의해 복부를 열고 대자의 스텐트 세그먼트뿐만 아니라 대자의 인접한 비 스텐트 부분을 제거하여 각각 0.5cm를 측정합니다.</li>
	<li>조직을 고정을 위해 24 시간 동안 4 % 완충 된 포르말린의 용액에 넣습니다.</li>
	<li>플라스틱에 스텐트 동맥 조직을 포함하고 표준프로토콜(18,19)에따른 조직학적 및 면역조직화학적 염색을 수행한다.</li>
</ol>6. 조직학적 분석
<ol><li>적절한 이미지 분석 소프트웨어가 있는 컴퓨터에 연결된 현미경을 통해 스텐트 대어의 근위, 중간 및 단면 부분의 순차적 섹션에 대한 조직학적 분석을 수행한다.</li>
	<li>외부 탄성 라미나 (EEL, 출현과 미디어 사이), 내부 탄성 라미나 (IEL, 미디어와 네오티마 사이), 그래픽 드로잉 태블릿루멘의 윤곽을 추적합니다. 이러한 값에서 소프트웨어로 EEL 영역, IEL 영역 및 루멘 영역을 계산합니다.</li>
	<li>스텐트 내 의 백분율 단면 영역(ISR)을 계산합니다. <img alt="Equation 1" src="/files/ftp_upload/61442/61442equ01.jpg">
</li>
	<li>총 신자극 영역(Ai)을계산합니다. <img alt="Equation 2" src="/files/ftp_upload/61442/61442equ02.jpg">
</li>
	<li>스트럿과 루멘 사이의 거리로 각 스텐트 스트럿에 네오인티알 두께(NIT)를 측정합니다. 이엘과 루멘 사이의 거리로 스텐트 스트럿 사이의 NIT를 측정합니다. 참고: 또는 NIT를 계산합니다. <img alt="Equation 3" src="/files/ftp_upload/61442/61442equ03.jpg"> 여기서 PL과 PIEL은 루멘과 내부 탄성 라미나 둘레, 각각20.</li>
	<li>연구의 요구 사항에 따라 추가 분석을 수행합니다.</li>
</ol>

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S. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Preclinical+restenosis+models:+challenges+and+successes.">Preclinical restenosis models: challenges and successes.</a> Toxicologic Pathology. 34 (1), 11-18 (2006).</li><li>Wei, S., 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=Apolipoprotein+E-deficient+rats+develop+atherosclerotic+plaques+in+partially+ligated+carotid+arteries.">Apolipoprotein E-deficient rats develop atherosclerotic plaques in partially ligated carotid arteries.</a> Atherosclerosis. 243 (2), 589-592 (2015).</li><li>Zhao, Y., 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=Hyperlipidemia+induces+typical+atherosclerosis+development+in+Ldlr+and+Apoe+deficient+rats.">Hyperlipidemia induces typical atherosclerosis development in Ldlr and Apoe deficient rats.</a> Atherosclerosis. 271, 26-35 (2018).</li><li>Ekuni, D., 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=Occlusal+disharmony+accelerates+the+initiation+of+atherosclerosis+in+apoE+knockout+rats.">Occlusal disharmony accelerates the initiation of atherosclerosis in apoE knockout rats.</a> Lipids in Health and Disease. 13 (144), 13 (2014).</li><li>Bhattacharya, D., Van Meir, E. G. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=A+simple+genotyping+method+to+detect+small+CRISPR-Cas9+induced+indels+by+agarose+gel+electrophoresis.">A simple genotyping method to detect small CRISPR-Cas9 induced indels by agarose gel electrophoresis.</a> Scientific Reports. 9 (1), 39950 (2019).</li><li>Malik, N., 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=Intravascular+stents:+a+new+technique+for+tissue+processing+for+histology,+immunohistochemistry,+and+transmission+electron+microscopy.">Intravascular stents: a new technique for tissue processing for histology, immunohistochemistry, and transmission electron microscopy.</a> Heart. 80 (5), 509-516 (1998).</li><li>Kumar, A. H., McCauley, S. D., Hynes, B. G., O'Dea, J., Caplice, N. M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Improved+protocol+for+processing+stented+porcine+coronary+arteries+for+immunostaining.">Improved protocol for processing stented porcine coronary arteries for immunostaining.</a> Journal of Molecular Histology. 42 (2), 187-193 (2011).</li><li>Jiang, Z., 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=A+novel+vein+graft+model:+adaptation+to+differential+flow+environments.">A novel vein graft model: adaptation to differential flow environments.</a> American Journal of Physiology - Heart and Circulatory Physiology. 286 (1), 18 (2004).</li><li>Cornelissen, A., 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=Apolipoprotein+E+deficient+rats+generated+via+zinc-finger+nucleases+exhibit+pronounced+in-stent+restenosis.">Apolipoprotein E deficient rats generated via zinc-finger nucleases exhibit pronounced in-stent restenosis.</a> Scientific Reports. 9 (1), 54541 (2019).</li><li>Ritskes-Hoitinga, M. G. T., Jensen, T. L., Mikkelsen, L. F. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=.">.</a> The Laboratory Mouse (Second Edition). , 567-599 (2012).</li><li>Rune, I., 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=Long-term+Western+diet+fed+apolipoprotein+E-deficient+rats+exhibit+only+modest+early+atherosclerotic+characteristics.">Long-term Western diet fed apolipoprotein E-deficient rats exhibit only modest early atherosclerotic characteristics.</a> Scientific Reports. 8 (1), 23835 (2018).</li><li>Daemen, J., 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=Early+and+late+coronary+stent+thrombosis+of+sirolimus-eluting+and+paclitaxel-eluting+stents+in+routine+clinical+practice:+data+from+a+large+two-institutional+cohort+study.">Early and late coronary stent thrombosis of sirolimus-eluting and paclitaxel-eluting stents in routine clinical practice: data from a large two-institutional cohort study.</a> Lancet. 369 (9562), 667-678 (2007).</li><li>Cornelissen, A., Vogt, F. J. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+effects+of+stenting+on+coronary+endothelium+from+a+molecular+biological+view:+Time+for+improvement.">The effects of stenting on coronary endothelium from a molecular biological view: Time for improvement.</a> Journal of Cellular and Molecular Medicine. 23 (1), 39-46 (2019).</li><li>Mori, H., 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=Pathological+mechanisms+of+left+main+stent+failure.">Pathological mechanisms of left main stent failure.</a> International Journal of Cardiology. 263, 9-16 (2018).</li><li>Wolinsky, H., Glagov, S. <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+abdominal+and+thoracic+aortic+medial+structure+in+mammals.+Deviation+of+man+from+the+usual+pattern.">Comparison of abdominal and thoracic aortic medial structure in mammals. Deviation of man from the usual pattern.</a> Circulation Research. 25 (6), 677-686 (1969).</li><li>Lowe, H. C., James, B., Khachigian, L. M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=A+novel+model+of+in-stent+restenosis:+rat+aortic+stenting.">A novel model of in-stent restenosis: rat aortic stenting.</a> Heart. 91 (3), 393-395 (2005).</li><li>Unthank, J. L., Nixon, J. C., Lash, J. M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Early+adaptations+in+collateral+and+microvascular+resistances+after+ligation+of+the+rat+femoral+artery.">Early adaptations in collateral and microvascular resistances after ligation of the rat femoral artery.</a> Journal of Applied Physiology. 79 (1), 73-82 (1985).</li><li>Nevzati, 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=Biodegradable+Magnesium+Stent+Treatment+of+Saccular+Aneurysms+in+a+Rat+Model+-+Introduction+of+the+Surgical+Technique.">Biodegradable Magnesium Stent Treatment of Saccular Aneurysms in a Rat Model - Introduction of the Surgical Technique.</a> Journal of Visualized Experiments. (128), e56359 (2017).</li><li>Aquarius, R., Smits, D., Gounis, M. J., Leenders, W. P. 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>

저자는 공개 할 것이 없습니다.

이 프로토콜은 apoE-/-쥐의 복부 대동맥에 인간 크기의 관상 동맥 스텐트의 이식을 설명합니다. 몇 가지 기술적 인 점은 강조 가치가있다. 첫째, 스텐트 크기와 대자의 크기 사이의 불일치는 피해야 합니다. 스텐트를 너무 작게 두면 스텐트 말라프포지션으로 이어질 수 있지만 대마에 비해 너무 큰 스텐트를 이식하면 혈관의 오버스트레치, 찢어짐 및 부상을 유발할 수 있습니다. 따라서 직경...

관상 동맥 스텐트의 배치와 결합된 경피 관상 동맥 개입(PCI)은 관상 동맥 질환1의중재 적 치료에 있는 금본위제(gold standard)를 나타낸다. 그러나 스텐트의 장기적인 성공은 스텐트2,3내의 신자극 조직의 과도한 증식에 의해 결정되는 스텐트 내 레스테노시스(ISR)의 발생에 의해 제한될 수 있다. ISR은 관상 동맥 우회 또는 재PCI로 재개입을 요구할 수 있습니다. ISR의 연구를 위해 다양한 동물 모델이 제안되었으며, 각각은 장점과 단점을 특징으로합니다. 가장 일반적으로 사용되는 돼지 관상 동맥 및 토끼 일강 동맥 모델의 주요 단점은 스텐트 이식후인간과 현저하게 유사한 병변을 개발하지만4,5,특히 장기 연구에서 물류 어려움을 초래하는 큰 동물 및 주거 비용뿐만 아니라 취급 및 장비의 한계입니다. 또한 돼지와 토끼의 세포 단백질에 대한 항체의 가용성은 제한적입니다. 한편, 뮤린 모델은 높은 처리량과 재현성의 주요 장점뿐만 아니라 취급, 하우징 및 비용 효율성의 용이성을 제공합니다. 더욱이, 항체의 더 많은 수를 사용할 수 있습니다. 그러나, 아포포단백질 E-결핍(apoE-/-) 마우스는 죽상경화증6,7,8의연구에 광범위하게 사용되어 왔지만, 스텐트가 마우스로 이식되기 위해 소형화되어야 하기 때문에 ISR 연구에 적합하지 않아 스텐트의 기계적 특성을 잠재적으로 변화시킬 수 있다. 더욱이, 마우스의 대동맥벽은 젊은 마우스에서 50 μm,구생9에서85 μm 사이를 측정하고, 스텐트는 스텐트10의malapposition로 이어질 수 있는 2 atm의 낮은 압력 수준을 사용하여 배치되어야 한다. 그러나 쥐는 시판되는 인간 관상 동맥 스텐트의 이식을 허용하고, 대동맥 스텐트 이식 후 더 큰 동물과 유사한 혈관 치유 과정을 시연하고, 랑베벨드 외11에의해 처음 보고되었다. 이 기술은 원래 혈액 흐름의 일시적인 중단을 달성하기 위해 대자의 물리적 수축을 필요로 트랜스 복부 액세스를 필요로했다. 잠재적으로 연관된 혈관 상해 및 염증 반응을 피하기 위하여는, 기술은 나중에 동물 의 더 높은 생존율 귀착되는 trans-iliac 접근의 도입에 의해 정제되었다12.
야생형 쥐는 죽상 경화성병변(13)을개발하지 않기 때문에, 아포-/-랫트는 전사 활성제-이펙터-이펙터 뉴클레아제(TALEN)14,군집이 정기적으로 짧은 팔린드로믹 반복(CRISPR/Cas9)15,아연 핑거(ZF)16등의핵활성 기술을 사용하여 생성되었다. ApoE-/-쥐는 2011년부터 상용화되어 왔습니다. 아포겐성 배경을 제공하는apoE-/-랫은 특히 ISR과 관련하여 인간 크기의 관상 동맥 스텐트의 보다 현실적인 평가를 허용합니다.
본원에서, 당사는 트랜스페모랄 접근 경로를 통해 서판적으로 이용 가능한 얇은 스트럿 코발트 크롬 약물 용출 스텐트(DES)를 사용하여 방법을 설명하지만, 베어 메탈 스텐트(BMS) 또는 생분해성 스텐트와 같은 다른 스텐트 유형의 연구에도 적용될 수 있다.

<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

관상 동맥 스텐트의 배치와 결합된 경피 관상 동맥 개입 (PCI)은 관상 동맥 질환의 중재 적 치료에 금 본위제입니다. 스텐트 내 레스테노스(ISR)는 스텐트 내의 신자극 조직의 과도한 증식에 의해 결정되며 스텐트의 장기적인 성공을 제한한다. 다양한 동물 모델이 스텐트 내 레스텐소증(ISR)의 기초병리학적 과정을 해명하는 데 사용되었으며, 돼지 관상 동맥 및 토끼 일강 동맥 모델이 가장 빈번하게 사용되고 있다. Murine 모델은 높은 처리량, 취급 및 하우징의 용이성, 재현성 및 분자 마커의 광범위한 가용성의 이점을 제공합니다. 아포포포프로틴 E결핍(apoE-/-) 마우스 모델은 심혈관 질환을 연구하는 데 널리 사용되고 있다. 그러나, 스텐트는 그들의 기계및 (잠재적으로) 생물학 속성의 중요한 변경을 관련시키는 마우스로 이식되기 위하여 소형화되어야 합니다. apoE-/--쥐의 사용은 apoE-/-쥐가 인간 크기의 관상 동맥 스텐트의 평가를 동시에 허용하는 동시에 아포로겐성 표현형을 제공하는 이러한 단점을 극복할 수 있다. 이것은 스텐트 이식 후 ISR을 조사하는 우수하고 신뢰할 수있는 모델입니다. 여기에서, 우리는, 상세히, 트랜스 대퇴접근을 사용하여 apoE-/- 배경을 가진 쥐의 복부 대동맥으로 상업적으로 이용 가능한 인간 관상 동맥 스텐트의 이식을 기술합니다.

이 프로토콜은 트랜스 대퇴 접근 경로를 사용하여 쥐의 복부 대어타에서 스텐트 이식을 설명합니다(도1). 이 동물 모델의 첫 번째 핵심포인트는 인간 크기의 관상 동맥 스텐트를 배치할 수 있다는 것입니다. 상업적으로 이용 가능한 압착 및 풍선 장착 관상 동맥 스텐트는 쥐의 복부 대동맥에 배치 할 수 있습니다. 따라서, 또한, 인간과 동일한 스텐트 배치 원칙을 적용할 수 ?...

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

이 프로토콜은 트랜스 대퇴 액세스를 사용하여 apoE-/- 배경을 가진 쥐의 복부 대동맥에 인간 관상 동맥 스텐트를 이식하는 것을 설명합니다. 다른 동물 모델과 비교하여 뮤린 모델은 높은 처리량, 재현성, 취급 및 하우징의 용이성 및 광범위한 분자 마커의 장점을 가지고 있습니다.

대퇴동맥 접근을 이용한 쥐 복부 대동맥에 인간 크기의 관상 동맥 스텐트를 이식

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 조회수.  University Hospital RWTH Aachen. 이 프로토콜은 트랜스 대퇴 액세스를 사용하여 apoE-/- 배경을 가진 쥐의 복부 대동맥에 인간 관상 동맥 스텐트를 이식하는 것을 설명합니다. 다른 동물 모델과 비교하여 뮤린 모델은 높은 처리량, 재현성, 취급 및 하우징의 용이성 및 광범위한 분자 마커의 장점을 가지고 있습니다.

비디오: 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 - 인감 : 누출에서 잘라 대장암 문합 보호 Biofragmentable 드레인

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

연구

의학

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.

쥐 이소성 복부 심장 / 볼륨로드 구성에서 단일 폐 이식

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

Ultrasound Based Assessment of Coronary Artery Flow and Coronary Flow Reserve Using the Pressure Overload Model in Mice

Transthoracic Doppler echocardiography (TTDE) is a clinically useful, noninvasive tool for studying coronary artery flow velocity and coronary flow reserve (CFR) in humans. Reduced CFR is accompanied by marked intramyocardial and pericoronary fibrosis and is used as an indication of the severity of dysfunction. This study explores, step-by-step, the real-time changes measured in the coronary flow velocity, CFR and systolic to diastolic peak velocity (S/D) ratio in the setting of an aortic banding model in mice. By using a Doppler transthoracic imaging technique that yields reproducible and reliable data, the method assesses changes in flow in the septal coronary artery (SCA), for a period of over two weeks in mice, that previously either underwent aortic banding or thoracotomy. 
During imaging, hyperemia in all mice was induced by isoflurane, an anesthetic that increased coronary flow velocity when compared with resting flow. All images were acquired by a single imager. Two ratios, (1) CFR, the ratio between hyperemic and baseline flow velocities, and (2) systolic (S) to diastolic (D) flow were determined, using a proprietary software and by two independent observers. Importantly, the observed changes in coronary flow preceded LV dysfunction as evidenced by normal LV mass and fractional shortening (FS). 
The method was benchmarked against the current gold standard of coronary assessment, histopathology. The latter technique showed clear pathologic changes in the coronary artery in the form of peri-coronary fibrosis that correlated to the flow changes as assessed by echocardiography. 
The study underscores the value of using a non-invasive technique to monitor coronary circulation in mouse hearts. The method minimizes redundant use of research animals and demonstrates that advanced ultrasound-based indices, such as CFR and S/D ratios, can serve as viable diagnostic tools in a variety of investigational protocols including drug studies and the study of genetically modified strains.

Coronary flow reserve (CFR) is useful for assessment of myocardial oxygen demand and evaluation of cardiovascular risk. This study establishes a step-by-step transthoracic Doppler echocardiographic (TTDE) method for longitudinal monitoring of the changes in CFR, as measured from coronary artery in mice, under the experimental pressure overload of aortic banding.

마우스의 압력 과부하 모델을 사용하여 관상 동맥 흐름 및 관상 동맥 흐름 준비 제도 이사회의 초음파를 바탕으로 평가

Transthoracic Doppler echocardiography (TTDE) is a clinically useful, noninvasive tool for studying coronary artery flow velocity and coronary flow ...

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.

마우스의 복부 유착의 창조

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.

쥐의 복부 대동맥의 수축을 통해 심장 리모델링의 모델

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

Murine Echocardiography of Left Atrium, Aorta, and Pulmonary Artery

The present methodology teaches the investigator how to measure and use the LAV as a surrogate of chronic elevations in Left Ventricular diastolic pressure through echocardiography, as well as to obtain measurements of the Aorta and PA diameter in mice.
Mice older than 10 d of age can be analyzed using the present technique. The technique is composed of 3 main steps: set-up, image acquisition, and image analysis. The set-up step consists of getting the mouse anesthetized with 1% isoflurane, shaving it, and taping it in a supine position to a heated EKG board where the image acquisition will take place. The image acquisition step consists of learning to identify the cardiac structures and obtaining all the required images with its correspondent probe and axis in order to be able to calculate volumes and diameters. The image analysis step consists of measuring the previously acquired images with the aid of computer software.
Advantages of the proposed technique include a fast (15 min) procedure that would allow the researcher to evaluate interventions in a non-invasive, non-terminal approach and therefore follow the same mouse over time; each mouse can be used as its own control. This fact plus having the same operator perform all the acquisition and analysis for the entire experiment minimizes the limitation of operator-dependency. The present methodology is useful for mouse researchers in cardiovascular and pulmonary medicine.

The following protocol describes the methodology for the acquisition and analysis of echocardiographic images used to obtain the Left Atrial Volume (LAV), Aorta (Ao) diameter, and Pulmonary Artery (PA) diameter in mice. This technique is a non-invasive, non-terminal procedure that allows assessment of the cardiopulmonary function.

왼쪽 아트리움, 대동맥과 폐동맥의 쥐 심 초음파

The present methodology teaches the investigator how to measure and use the LAV as a surrogate of chronic elevations in Left Ventricular diastolic ...

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.

쥐 대동맥 또는 하대 정맥에 혈관 성형술 패치

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.

폐 동맥에서 좌측 관상 동맥의 변칙 기원과 성인에서 대동맥으로 왼쪽 관상 동맥의 직접 재 주입 (좌 관상 동맥 폐동맥 이상 연결 증)

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.

풍선-기반 부상 마우스 복 부 대동맥에서 Myointimal 증식을 유도 하

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 ...

Identifying Coronary Artery Calcification on Non-gated Computed Tomography Scans

Coronary artery calcification (CAC) provides an objective measure of coronary artery disease and can readily be identified on non-gated computed tomography (CT) scans with a high correlation with gated cardiac CT scans. This standardized protocol takes a step-wise approach to not only optimizing an image for the identification of calcification but also to distinguishing CAC from other common causes of calcification in the cardiac silhouette. Recognition of CAC on non-gated CT scans helps to identify a very powerful prognostic factor that can influence therapeutic interventions or downstream diagnostic testing without requiring a gated cardiac scan. These non-gated CT scans are often acquired as part of the routine care of the patient, and this data is readily available without another dose of&#160;ionizing radiation. This protocol allows for the precise and accurate extraction of this data for the purposes of retrospective data analysis in clinical research studies, but also in the clinical evaluation and management of patients.

Here, we present a protocol to reliably and systematically identify coronary artery calcification (CAC) on non-gated computed tomography (CT) scans of the chest or abdomen. CAC provides an objective measure of coronary artery disease for both research and clinical purposes.