Name: deep vein thrombosis induced by stasis in mice monitored by high frequency ultrasonography
Uploaded: 2018-04-13T14:00:00
Description: Watch this Scientific Journal Video about Deep Vein Thrombosis Induced by Stasis in Mice Monitored by High Frequency Ultrasonography at JoVE.com

This work was supported by a grant from the Heart and Stroke Foundation of Canada and by The Morris and Bella Fainman Family Foundation. The authors would like to thank Veronique Michaud for her technical help with the VEVO770 ultrasound imaging system.

All procedures were approved by the institutional Animal Care Committee of McGill University Montr&#233;al, QC, Canada. All the equipment required is listed in Table I.
1. Murine (C57BL/6J) IVC Stasis Protocol
<ol>
	<li>Surgery preparation 
	NOTE: This is a survival surgery and therefore, proper aseptic technique needs to be followed at all times. This includes making sure all materials are at hand, cleaning and sterilizing instruments before and between use, and design...

<ol>
	<li>Fowkes, F. J., Price, J. F., Fowkes, 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=Incidence+of+diagnosed+deep+vein+thrombosis+in+the+general+population:+systematic+review.">Incidence of diagnosed deep vein thrombosis in the general population: systematic review.</a> Eur J Vasc Endovasc Surg. 25 (1), 1-5 (2003).</li><li>McGuinness, C. L., 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=Recruitment+of+labelled+monocytes+by+experimental+venous+thrombi.">Recruitment of labelled monocytes by experimental venous thrombi.</a> Thromb Haemost. 85 (6), 1018-1024 (2001).</li><li>Singh, 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=Failure+of+thrombus+to+resolve+in+urokinase-type+plasminogen+activator+gene-knockout+mice:+rescue+by+normal+bone+marrow-derived+cells.">Failure of thrombus to resolve in urokinase-type plasminogen activator gene-knockout mice: rescue by normal bone marrow-derived cells.</a> Circulation. 107 (6), 869-875 (2003).</li><li>Itoh, K., Ieko, M., Hiraguchi, E., Kitayama, H., Tsukamoto, E. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=In+vivo+kinetics+of+99mTc+labeled+recombinant+tissue+plasminogen+activator+in+rabbits.">In vivo kinetics of 99mTc labeled recombinant tissue plasminogen activator in rabbits.</a> Ann Nucl Med. 8 (3), 193-199 (1994).</li><li>Kang, C., Bonneau, M., Brouland, J. P., Bal dit Sollier, C., Drouet, L. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=In+vivo+pig+models+of+venous+thrombosis+mimicking+human+disease.">In vivo pig models of venous thrombosis mimicking human disease.</a> Thromb Haemost. 89 (2), 256-263 (2003).</li><li>Knight, L. C., Baidoo, K. E., Romano, J. E., Gabriel, J. L., Maurer, A. H. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Imaging+pulmonary+emboli+and+deep+venous+thrombi+with+99mTc-bitistatin,+a+platelet-binding+polypeptide+from+viper+venom.">Imaging pulmonary emboli and deep venous thrombi with 99mTc-bitistatin, a platelet-binding polypeptide from viper venom.</a> J Nucl Med. 41 (6), 1056-1064 (2000).</li><li>Wakefield, T. W., 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=Venous+thrombosis+prophylaxis+by+inflammatory+inhibition+without+anticoagulation+therapy.">Venous thrombosis prophylaxis by inflammatory inhibition without anticoagulation therapy.</a> J Vasc Surg. 31 (2), 309-324 (2000).</li><li>Robins, R. 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=Vascular+Gas6+contributes+to+thrombogenesis+and+promotes+tissue+factor+up-regulation+after+vessel+injury+in+mice.">Vascular Gas6 contributes to thrombogenesis and promotes tissue factor up-regulation after vessel injury in mice.</a> Blood. 121 (4), 692-699 (2013).</li><li>Aghourian, M. N., Lemarie, C. A., Bertin, F. R., Blostein, M. D. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Prostaglandin+E+synthase+is+upregulated+by+Gas6+during+cancer-induced+venous+thrombosis.">Prostaglandin E synthase is upregulated by Gas6 during cancer-induced venous thrombosis.</a> Blood. 127 (6), 769-777 (2016).</li><li>Laurance, 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=Gas6+(Growth+Arrest-Specific+6)+Promotes+Inflammatory+(CCR2hiCX3CR1lo)+Monocyte+Recruitment+in+Venous+Thrombosis.">Gas6 (Growth Arrest-Specific 6) Promotes Inflammatory (CCR2hiCX3CR1lo) Monocyte Recruitment in Venous Thrombosis.</a> Arterioscler Thromb Vasc Biol. , (2017).</li><li>Diaz, J. 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=Critical+review+of+mouse+models+of+venous+thrombosis.">Critical review of mouse models of venous thrombosis.</a> Arterioscler Thromb Vasc Biol. 32 (3), 556-562 (2012).</li><li>Aghourian, M. N., Lemarie, C. A., Blostein, M. D. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=In+vivo+monitoring+of+venous+thrombosis+in+mice.">In vivo monitoring of venous thrombosis in mice.</a> J Thromb Haemost. 10 (3), 447-452 (2012).</li><li>Brandt, 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=Deep+vein+thrombus+formation+induced+by+flow+reduction+in+mice+is+determined+by+venous+side+branches.">Deep vein thrombus formation induced by flow reduction in mice is determined by venous side branches.</a> Clin Hemorheol Microcirc. 56 (2), 145-152 (2014).</li><li>Diaz, J. A., Farris, D. M., Wrobleski, S. K., Myers, D. D., Wakefield, T. W. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Inferior+vena+cava+branch+variations+in+C57BL/6+mice+have+an+impact+on+thrombus+size+in+an+IVC+ligation+(stasis)+model.">Inferior vena cava branch variations in C57BL/6 mice have an impact on thrombus size in an IVC ligation (stasis) model.</a> J Thromb Haemost. 13 (4), 660-664 (2015).</li><li>Luther, 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=Innate+Effector-Memory+T+Cell+Activation+Regulates+Post-Thrombotic+Vein+Wall+Inflammation+and+Thrombus+Resolution.">Innate Effector-Memory T Cell Activation Regulates Post-Thrombotic Vein Wall Inflammation and Thrombus Resolution.</a> Circ Res. , (2016).</li><li>Subramaniam, 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=Distinct+contributions+of+complement+factors+to+platelet+activation+and+fibrin+formation+in+venous+thrombus+development.">Distinct contributions of complement factors to platelet activation and fibrin formation in venous thrombus development.</a> Blood. 129 (16), 2291-2302 (2017).</li><li>Diaz, J. 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=Thrombogenesis+with+continuous+blood+flow+in+the+inferior+vena+cava.+A+novel+mouse+model.">Thrombogenesis with continuous blood flow in the inferior vena cava. A novel mouse model.</a> Thromb Haemost. 104 (2), 366-375 (2010).</li></ol>

There are several critical steps for successful venous thrombus formation using the stasis model. Induction of vein thrombosis is more challenging in old mice due to the accumulation of fat surrounding the inferior vena cava and the aorta. Ideally, mice undergoing this procedure should be 8 - 10-weeks-old. Great care should be taken not to induce endothelial damage in the IVC during the blunt dissection and ligature. In addition, it is crucial to keep the animal in a 34 &#176;C incubator for at least 30 minutes after the...

Venous thromboembolism (VTE), which is comprised of deep venous thrombosis (DVT) and pulmonary embolism, is the third leading cause of cardiovascular death after myocardial infarction and stroke. It is a common condition affecting 1 - 2% of the population, with an annual incidence of 1 in 5001. VTE can lead to: 1) death through pulmonary embolism; 2) post-thrombotic syndrome, characterized by chronic leg pain, swelling, and ulceration; or 3) chronic pulmonary hypertension resulting in significant chronic respiratory compromise. VTE is a multi-factorial disease and may result from stasis of blood flow, damage to vessel walls, and/or hypercoagulable states due to a disruption of the balance between the coagulation and the fibrinolytic systems, as it has been described over a hundred years ago by Virchow and is known as the Virchow&#39;s Triad.
Because in most cases it is impossible to obtain human DVT samples, researchers have developed experimental animal models of DVT. Several animals including rat2, mouse3, rabbit4, pig5, dog6, and non-human primate7 have been used. Mice can be genetically modified and are the most frequently used animal to study DVT. However, as in all animals, spontaneous DVT is not observed in mice. Thus, physical or chemical alterations of the vein wall are used to create thrombosis in mice. We have previously used the ferric chloride model to induce thrombosis in the inferior vena cava (IVC) of mice8,9,10. This model has the advantage of reliably producing occlusive thrombi within minutes and can be used to investigate the role of anti-coagulant and anti-platelet drugs during acute DVT. However, it is a terminal procedure. Thus, to study acute and chronic DVT, the stasis model is more suitable. In this model, thrombus formation is induced by the complete interruption of blood flow in the IVC, one of the factors in Virchow&#39;s triad for DVT development. This model can be used to study DVT formation and resolution, which is an advantage compared to the FeCl3 model11.
We have developed a non-invasive method to follow thrombus formation and resolution over time using a micro-imaging high-frequency ultrasound system12. We have previously demonstrated that measurement of venous thrombosis by ultrasound correlates favorably with thrombi obtained pathologically. We have confirmed in two subsequent studies that measurements obtained with ultrasound correlate with thrombus weight and thrombus area quantified by histochemistry9,10. More importantly, we have showed that high frequency ultrasound can be used to monitor the formation of deep venous thrombosis in mice12. It may also be used to quantify thrombus resolution in a non-invasive way.
Here, we will describe the protocol allowing thrombus formation using the stasis-induced thrombosis mouse model and how thrombus formation can be monitored non-invasively over time using high frequency ultrasound.

<table>
	<tbody>
		<tr>
			<td>6-0 perma-hand silk suture</td>
			<td>Ethicon</td>
			<td>706G</td>
			<td></td>
		</tr>
		<tr>
			<td>Surgical Scissors</td>
			<td>Fine Science Tools</td>
			<td>20830-00</td>
			<td></td>
		</tr>
		<tr>
			<td>Suture tying forceps</td>
			<td>Fine Science Tools</td>
			<td>20830-00</td>
			<td></td>
		</tr>
		<tr>
			<td>blunt forceps (straight and curved)</td>
			<td>Fine Science Tools</td>
			<td>20830-00</td>
			<td></td>
		</tr>
		<tr>
			<td>Needle Driver</td>
			<td>Fine Science Tools</td>
			<td>13002-10</td>
			<td></td>
		</tr>
		<tr>
			<td>Moria Spring Scissors</td>
			<td>Fine Science Tools</td>
			<td>15396-00</td>
			<td></td>
		</tr>
		<tr>
			<td>1ml syringes</td>
			<td>BD Biosciences</td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>26G needles</td>
			<td>Becton Dickinson &#38; Co.</td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>VEVO 770 High Resolution Imaging System</td>
			<td>Visualsonics</td>
			<td>No longer sold</td>
			<td></td>
		</tr>
		<tr>
			<td>SR Buprenorphine</td>
			<td>ZooPharm</td>
			<td></td>
			<td>Given to LDI by Vet</td>
		</tr>
		<tr>
			<td>Surgery Microscope</td>
			<td>Leica</td>
			<td>Leica M651</td>
			<td></td>
		</tr>
		<tr>
			<td>Systan eye oinment</td>
			<td>Alcon</td>
			<td>288/28062-0</td>
			<td></td>
		</tr>
		<tr>
			<td>2x2 sterile Gauze</td>
			<td>CDMV</td>
			<td>#104148</td>
			<td></td>
		</tr>
		<tr>
			<td>Cotton Tip Applicators</td>
			<td></td>
			<td></td>
			<td>from JGH</td>
		</tr>
		<tr>
			<td>Transpore hypoallergenic surgical tape</td>
			<td>CDMV</td>
			<td>#7411</td>
			<td></td>
		</tr>
		<tr>
			<td>Ultrasound gel (Aquasonic-100)</td>
			<td>Dufort &#38; Lavigne</td>
			<td>#AKEN4061</td>
			<td></td>
		</tr>
		<tr>
			<td>Incubator</td>
			<td></td>
			<td></td>
			<td>From JGH</td>
		</tr>
		<tr>
			<td>Isoflurane</td>
			<td>Dispomed</td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>Anesthetic chamber,hoses, and adminstration equipment</td>
			<td>Dispomed</td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>Hair remover</td>
			<td>Nair</td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>Water heated hard pad</td>
			<td>Braintree Scientific, Inc.</td>
			<td>#HHP-2</td>
			<td></td>
		</tr>
		<tr>
			<td>Gaymar heater water pump TP500</td>
			<td>MATVET Inc.</td>
			<td>#R-500305</td>
			<td></td>
		</tr>
		<tr>
			<td>Infra-red heating lamp</td>
			<td>electrimat inc.</td>
			<td>#1R175R-PAR</td>
			<td></td>
		</tr>
		<tr>
			<td>Mouse rectal temperature prope</td>
			<td>emkaTECHNOLOGIES</td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>Sterile water</td>
			<td></td>
			<td></td>
			<td>From JGH</td>
		</tr>
	</tbody>
</table>

deep vein thrombosis induced by stasis in mice monitored by high frequency ultrasonography

Venous thrombosis is a common condition affecting 1 - 2% of the population, with an annual incidence of 1 in 500. Venous thrombosis can lead to death through pulmonary embolism or results in the post-thrombotic syndrome, characterized by chronic leg pain, swelling, and ulceration, or in chronic pulmonary hypertension resulting in significant chronic respiratory compromise. This is the most common cardiovascular disease after myocardial infarction and ischemic stroke and is a clinical challenge for all medical disciplines, as it can complicate the course of other disorders such as cancer, systemic disease, surgery, and major trauma.
Experimental models are necessary to study these mechanisms. The stasis model induces consistent thrombus size and a quantifiable amount of thrombus. However, it is necessary to systematically ligate side branches of the inferior vena cava to avoid variability in thrombus sizes and any erroneous data interpretation. We have developed a non-invasive technique to measure thrombus size using ultrasonography. Using this technique, we can assess thrombus development and resolution over time in the same animal. This approach limits the number of mice required for quantification of venous thrombosis consistent with the principle of replacement, reduction, and refinement of animals in research. We have demonstrated that thrombus weight and histological analysis of thrombus size correlate with measurement obtained with ultrasonography. Therefore, the current study describes how to induce deep vein thrombosis in mice using the inferior vena cava stasis model and how to monitor it using high frequency ultrasound.

Stasis venous thrombosis model
In the stasis model, mice are anesthetized, and an incision is made to expose the inferior vena cava (IVC). The incision is made on the left or right side of the mouse instead of a midline laparotomy in a way that would not interfere with the ultrasound probe. The abdominal muscles and the skin are fold back to expose the IVC (Figure 1). First, side br...

Watch this Scientific Journal Video about Deep Vein Thrombosis Induced by Stasis in Mice Monitored by High Frequency Ultrasonography at JoVE.com

Deep Vein Thrombosis Induced by Stasis in Mice Monitored by High Frequency Ultrasonography

The present protocol describes the steps to obtain venous thrombosis using a stasis model. In addition, we are using a non-invasive method to measure thrombus formation and resolution over time.

Venous thrombosis is a common condition affecting 1 - 2% of the population, with an annual incidence of 1 in 500. Venous thrombosis can lead to death ...

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