Name: microsurgical venous pouch arterial-bifurcation aneurysms in the rabbit model: technical aspects
Uploaded: 2011-05-11T13:00:00
Description: Watch this Scientific Journal Video about Microsurgical Venous Pouch Arterial-Bifurcation Aneurysms in the Rabbit Model: Technical Aspects at JoVE.com

Questo studio è stato sostenuto dal &#39;Fondo Medico Scientifico del Sindaco della Città di Vienna&#39; e Biosurgery Ethicon, Inc. New Jersey, USA. Gli autori esprimono il loro ringraziamento al professor Heber Ferraz-Leite, direttore del &#39;Workshop europeo sul Microchirurgia e rivascolarizzazione cerebrale&#39; presso l&#39;Università di Medicina di Vienna, in Austria, per il suo insegnamento prezioso microchirurgia.

1. Posizionamento e preparazione degli animali Gli esperimenti sono stati approvati dal responsabile del comitato etico locale ed eseguito secondo le linee guida Felasa. <ol><li> Inizio anestesia generale della femmina Nuova Zelanda bianco coniglio (2,5-3,5 kg) con iniezione intramuscolare di Ketamin (30mg/kg) e xilazina (6mg/kg) e continuare dopo l&#39;intubazione meccanica (tubo di diametro 4 mm, lunghezza 18 mm) con l&#39;anestesia gas ( ) isoflurano sotto monitoraggio ECG. Eseguire il ...

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	<li>Molyneux, A., Kerr, R., Yu, L. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=International+subarachnoid+aneurysm+trial+(ISAT)+of+neurosurgical+clipping+versus+endovascular+coiling+in+2143+patients+with+ruptured+intracranial+aneurysms:+a+randomised+comparison+of+effects+on+survival,+dependency,+seizures,+rebleeding,+subgroups,+and+aneurysm+occlusion.">International subarachnoid aneurysm trial (ISAT) of neurosurgical clipping versus endovascular coiling in 2143 patients with ruptured intracranial aneurysms: a randomised comparison of effects on survival, dependency, seizures, rebleeding, subgroups, and aneurysm occlusion.</a> Lancet. 366, 809-817 (2005).</li><li>Mitchell, P., Kerr, R., Mendelow, A., Molyneux, A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Could+late+rebleeding+overturn+the+superiority+of+cranial+aneurysm+coil+embolization+over+clip+ligation+seen+in+the+International+Subarachnoid+Aneurysm+Trial.">Could late rebleeding overturn the superiority of cranial aneurysm coil embolization over clip ligation seen in the International Subarachnoid Aneurysm Trial.</a> J Neurosur. 108, 437-442 (2008).</li><li>Bavinzski, G. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Histopathological+findings+in+experimental+aneurysms+embolized+with+conventional+and+thrombogenic/antithrombolytic+Guglielmi+coils.">Histopathological findings in experimental aneurysms embolized with conventional and thrombogenic/antithrombolytic Guglielmi coils.</a> Minim Invasive Neurosurg. 42, 167-174 (1999).</li><li>Bocher-Schwarz, H. G. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Histological+findings+in+coil-packed+experimental+aneurysms+3+months+after+embolization.">Histological findings in coil-packed experimental aneurysms 3 months after embolization.</a> Neurosurgery. 50, 379-384 (2002).</li><li>Sherif, C., Plenk, H., Grossschmidt, K., Kanz, F., Bavinzski, G. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Computer-assisted+quantification+of+occlusion+and+coil+densities+on+angiographic+and+histological+images+of+experimental+aneurysms.">Computer-assisted quantification of occlusion and coil densities on angiographic and histological images of experimental aneurysms.</a> Neurosurgery. 58, 559-566 (2006).</li><li>Massoud, T., Guglielmi, G., Ji, C. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Experiemental+saccular+aneurysms.+1.+Review+of+surgically+constructed+models+and+their+laboratory+applications.">Experiemental saccular aneurysms. 1. Review of surgically constructed models and their laboratory applications.</a> Neurorad. 36, 537-546 (1994).</li><li>Anidjar, S., Salzmann, J., Gentric, D. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Elastase+induced+experimental+aneurysms+in+rats.">Elastase induced experimental aneurysms in rats.</a> Circulation. 82, 973-981 (1990).</li><li>Wakhloo, A., Schellhammer, F., 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=Self-expanding+and+balloon-expandable+stents+in+the+treatment+of+carotid+aneurysms:+an+experimental+study+in+a+canine+model.">Self-expanding and balloon-expandable stents in the treatment of carotid aneurysms: an experimental study in a canine model.</a> AJNR. 15, 493-502 (1994).</li><li>Dai, D. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Histopathologic+and+immunohistochemical+comparison+of+human,+rabbit,+and+swine+aneurysms+embolized+with+platinum+coils.">Histopathologic and immunohistochemical comparison of human, rabbit, and swine aneurysms embolized with platinum coils.</a> AJNR Am J Neuroradiol. 26, 2560-2568 (2005).</li><li>Shin, Y. S. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Creation+of+four+experimental+aneurysms+with+different+hemodynamics+in+one+dog.">Creation of four experimental aneurysms with different hemodynamics in one dog.</a> AJNR. 26, 1764-1767 (2005).</li><li>Abruzzo, T. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Histologic+and+morphologic+comparison+of+experimental+aneurysms+with+human+intracranial+aneurysms.">Histologic and morphologic comparison of experimental aneurysms with human intracranial aneurysms.</a> AJNR Am J Neuroradiol. 19, 1309-1314 (1998).</li><li>Bavinzski, G. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Experimental+bifurcation+aneurysm:+a+model+for+in+vivo+evaluation+of+endovascular+techniques.">Experimental bifurcation aneurysm: a model for in vivo evaluation of endovascular techniques.</a> Minim Invasive Neurosurg. 41, 129-132 (1998).</li><li>Spetzger, U. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Microsurgically+produced+bifurcation+aneurysms+in+a+rabbit+model+for+endovascular+coil+embolization.">Microsurgically produced bifurcation aneurysms in a rabbit model for endovascular coil embolization.</a> J Neurosurg. 85, 488-495 (1996).</li><li>Sherif, C., Marbacher, S., Erhardt, S., Fandino, J., J, . <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Improved+microsurgical+creation+of+venous-pouch+arterial-bifurcation+aneurysms+in+rabbits.">Improved microsurgical creation of venous-pouch arterial-bifurcation aneurysms in rabbits.</a> AJNR. , .</li><li>Marbacher, S. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Complex+Bi-Lobular,+Bi-Saccular,+and+Broad-Necked+Microsurgical+Aneurysms+Formation+in+the+Rabbit+Bifurcation+Model+for+the+Study+of+Upcoming+Endovascular+Techniques.">Complex Bi-Lobular, Bi-Saccular, and Broad-Necked Microsurgical Aneurysms Formation in the Rabbit Bifurcation Model for the Study of Upcoming Endovascular Techniques.</a> AJNR. , .</li><li>Sherif, C., Plenk, H. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Quantitative+angiographic+and+histopathologic+evaluation+of+experimental+aneurysms.">Quantitative angiographic and histopathologic evaluation of experimental aneurysms.</a> AJNR. , .</li><li>Grunwald, I. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Anticoagulation+regimes+and+their+influence+on+the+occlusion+rate+of+aneurysms:+an+experimental+study+in+rabbits.">Anticoagulation regimes and their influence on the occlusion rate of aneurysms: an experimental study in rabbits.</a> Neurosurg. 57, 1048-1054 (2005).</li><li>Forrest, M. D., O'Reilly, G. V. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Production+of+experimental+aneurysms+at+a+surgically+created+arterial+bifurcation.">Production of experimental aneurysms at a surgically created arterial bifurcation.</a> AJNR Am J Neuroradiol. 10, 400-402 (1989).</li></ol>

Gli autori raccomandano di riguardoso le seguenti critiche fasi chirurgiche chiave per ottenere buoni risultati ed aneurismi di brevetto: <ol><li> Dissezione attenta di un segmento lungo della sinistra CCA per anastomosi facile senza la distruzione di nervi e piccoli vasi. </li><li> Attenta rimozione del tessuto fibroso molto trombogenico periadventitial prima della creazione delle anastomosi. </li><li> Creazione di una anastomosi senza tensione. </li><li> Meno punti di sutura: La sequenza proposta dei siti anastoms...

<table border="1"><tbody><tr><th> Nome del reagente </th><th> Azienda </th><th> Numero di catalogo </th><th> Commenti </th></tr><tr><td> Vicryl4-0 polyfilament suture ripristinabili </td><td> Ethicon Inc </td><td> J386H </td><td></td></tr><tr><td> Ethilon 10-0 monofilati suture non riassorbibili </td><td> Ethicon Inc </td><td> 2814 </td><td> cono punta dell&#39;ago </td></tr><tr><td> Evicel Bioglue </td><td> Ethicon Biosurgery Inc. </td><td> 3901 </td><td></td></tr><tr><td> Fentanil cerotto cutaneo 12,5 mcg / h </td><td></td><td></td><td> Qualsiasi genericon </td></tr><tr><td> Eparina </td><td></td><td></td><td> Qualsiasi genericon </td></tr><tr><td> 0,9% Saline </td><td></td><td></td><td> Qualsiasi genericon </td></tr><tr><td> 4% Papaverin HCl </td><td></td><td></td><td> Qualsiasi genericon </td></tr><tr><td> Neomicina solfato di 5 mg / ml </td><td></td><td></td><td> Qualsiasi genericon </td></tr><tr><td> Ketamin 50mg/ml </td><td></td><td></td><td> Qualsiasi genericon </td></tr><tr><td> Xylazina 20mg/ml </td><td></td><td></td><td> Qualsiasi genericon </td></tr></tbody></table>

microsurgical venous pouch arterial-bifurcation aneurysms in the rabbit model: technical aspects

Per la rottura di aneurisma cerebrale umana embolizzazione endovascolare è diventata un&#39;alternativa equivalente al ritaglio aneurisma. 1 Tuttavia, ampi studi clinici hanno dimostrato deludenti risultati a lungo termine con inaccettabili alti tassi di ricanalizzazione dell&#39;aneurisma e della rottura dell&#39;aneurisma ritardata. 2 Per superare questi problemi, animale studi sperimentali sono cruciali per lo sviluppo di migliori dispositivi endovascolari. 3-5 Diversi modelli animali nei ratti, conigli, cani e porci sono disponibili. 6-8 confronto dei diversi modelli animali ha dimostrato la superiorità di questo modello animale per quanto riguarda i emodinamica e comparabilità del sistema di coagulazione e di costo-efficacia. 9-11 Il sacchetto venoso arterioso modello biforcazione nei conigli è formata da un sacchetto venosa suturata in una biforcazione creata artificialmente vero di entrambe le arterie della carotide comune (CCA). Il vantaggio principale di questo modello sono vere emodinamica bifurcational. 12 I principali svantaggi sono le richieste di microchirurgia sofar elevato livello tecnico e alta morbilità e mortalità fino al 50%. 13 Queste limitazioni hanno portato ad un minor uso frequente di questo modello aneurisma nel recente anni. Queste carenze possono essere superate con il miglioramento delle procedure chirurgiche e modificato peri-e postoperatoria gestione analgesico e anticoagulante. 14-16 nostre tecniche riportate in questo documento dimostrano questa tecnica microchirurgica ottimizzato per la creazione di aneurismi biforcazione arteriosa.

Watch this Scientific Journal Video about Microsurgical Venous Pouch Arterial-Bifurcation Aneurysms in the Rabbit Model: Technical Aspects at JoVE.com

Microsurgical Venous Pouch Arterial-Bifurcation Aneurysms in the Rabbit Model: Technical Aspects

Una tecnica ottimizzata per la creazione microchirurgico di aneurismi arteriosi biforcazione imitando biforcazione aneurismi cerebrale umana è descritta. Un sacchetto venoso viene suturata in una biforcazione creata artificialmente vero di entrambe le arterie carotidi comuni. Tecniche microchirurgiche facilitato ed aggressiva terapia anticoagulante ed analgesia postoperatoria portare a tassi di morbilità ridotta al minimo e alti tassi di pervietà aneurisma.

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