Name: electrolytic inferior vena cava model (eim) of venous thrombosis
Uploaded: 2011-07-12T13:00:00
Duration: 6 min 3 s
Description: Watch this Scientific Journal Video about Electrolytic Inferior Vena Cava Model EIM of Venous Thrombosis at JoVE.com

NIH 1P01HL089407 - 01A1（ローレンス、PI）、動物のコアA、NIH 1 K01 HL080962 - 01A2（マイヤーズ、PI）によってサポートされています。

1。マウスの麻酔の手順<ol><li>動物は彼らのケージから取り出し、2％イソフルランと毎分0.5リットル（気化器制御）の流量で100％酸素でガスの誘導のための麻酔術前誘導のチャンバー内に配置されます。 </li><li>マウスは、麻酔の誘導チャンバ内鎮静チャンバーから除去し、髪の毛の脱毛は、（1分間）使用されている場合は腹側腹部を電気バリカンで剃毛、またはチャンバー内に保持されています。 </li><li>まだ鎮静下で、彼らの重量を測定している間、目がその後イソフルランと酸素を使用してノーズコーンと全身麻酔下に温水循環加熱装置に背recumbancyに配置された無菌の眼軟膏と、で潤滑されています。この時点で、酸素の割合は、毎分0.2リットルに削減されます。 </li><li>腹部はクロルヘキシジン液（クロルヘキシジン二酢酸は急速にbacterialcidalと持続性がある）を噴霧し、滅菌ガーゼで拭いて三回か手術部位はきれいになるまでさ。 </li></ol> 2。マウスマイクロ外科および回復手順<ol><li>腹側正中切開（2 cm）を腹部を露出皮膚や腹壁を通して虹彩をハサミで作られています。ガーゼの滅菌生理食塩水浸漬した2x2のは動物の左側に腸を反映するために使用されます。マウスの制止する人は、下大静脈（IVC）の可視化を可能にする場所に置かれている。 </li><li>この時点では、イソフルランを2％の保守レベルに低減され、酸素の割合は、外科的処置の残りのための毎分0.2リットルのままです。 </li><li>鈍的切開は、滅菌アプリケーター綿棒や余分な繊細な虹彩の半分の湾曲した組織鉗子を用いて促進される。ケアは、彼らは非常に壊れやすいために、マウス組織の取り扱いには注意が必要です。 </li><li>腎静脈から腸骨分岐へのすべてのIVCの側枝は、,7 - 0非反応性prolene縫合糸で結紮されています。バックの枝は、特許残った。 </li><li>電解IVCモデル（EIM）には、銀コーティング銅線（KY - 30 - 1 - GRN、Electrospec、ドーバー、ニュージャージー州）に接続されている25Gのステンレススチール針は、露出尾IVC、（図1）に挿入されますと前壁（陽極）に対して配置されます。 </li><li>別の線は、皮下回路（カソード）を完了注入される。 </li><li> 15分250以上のμAmpsの現在はグラスS48矩形波刺激装置と定電流ユニット（グラステクノロジー、アストロメッド社、ウェストワーウィ​​ック、ロードアイランド）を使用して適用した。血栓形成の環境とそれに続く血栓形成を促進するIVCの内皮表面を侵食し電気分解の有毒な生成物の形成における直流結果。 </li><li> 15分後、針が削除され、綿棒は、出血を防ぐために、地域との接触で穏やかに開催されます</li><li>シャム動物では、針は現在のアプリケーションなしで、IVC内に配置されてから削除されます。 </li><li>開腹部位は、2層方式で閉じられます。当研究室では、腹壁を閉じるには、連続的なパターンで5〜0 vicryl、合成縫合糸を、使用しています。接着剤の皮膚接着剤は、皮膚を閉じるために使用されます。除去するための外付縫合糸はありません。 </li><li>マウスは、その後、元の住宅に戻って、密接に加熱ランプ（24インチ離れてケージから分の距離）の下（2時間まで45分）手術後に観察された、個々のマウスのケージに回収されています。それは研究目的に干渉していない場合の鎮痛薬と抗炎症剤を用いることができる。科学的な鎮痛剤を差し控えることを正当化、獣医、そしてICUCAの承認が必要とされています。当研究室では、ブプレノルフィン,0.05 - 0 .1 mg / kgのSQは、マウスのための優秀なプリと術後の鎮痛剤であることを見出した。全身鎮痛薬は、実験結果を混乱させる可能性がある場合に加えて、4mg/kgでのリドカインは、（0.4 mlの1％溶液の/ kg）の切開部位に注入することができます。 </li><li>我々は一般的にDVTに起因する術後の副作用は発生しません。しかし、不利な術後の効果は、自発的な麻酔死、手術の失血、および神経の外傷に起因する部分的な麻痺を含めることができます。回復が遅い動物が飼育ヌートリアゲルであるか湿った固形飼料は、動物の回復を促進するためにケージの床に置くことができます。断絶術後合併症を有する動物を人道的に安楽死されるべきである。 </li><li>割り当てられた時点で、安楽死は、げっ歯類のための安楽死についてアメリカ獣医学協会のガイドラインで定められている勧告に従って人道的に行われます。 </li></ol> 3。代表的な結果 EIMは、連続的な血流の存在下で血栓形成モデルです。次の図は、このような斬新なモデルで検討したパラメータを示す。 <img src="/files/ftp_upload/2737/2737fig1.jpg" alt="図1" /> 図1 25Gステンレス鋼のdefinesthe解剖学的領域銀被覆銅線（KY - 30 - 1 - GRN、Electrospec、ドーバー、ニュージャージー州）に接続されている針は、挿入されます。リンパ節がほとんど存在していると尾IVCを見つけるために目印として役立つことに注意してください。 <img src="/files/ftp_upload/2737/2737fig2.jpg" alt="図2" /> 図2：2日間、異なる菌株のEIM後の血栓重量。予想されたように、血栓重量はPAI - 1 KOマウスと凝固亢進デルタCTマウスで大きい（^ CT）で低かった。 <img src="/files/ftp_upload/2737/2737fig3.jpg" alt="図3" /> 図3：可溶性P -セレクチン、深部静脈血栓症のためのメーカーは、異なる株で測定した。最高レベルが亢進デルタCTマウスで発見されたのに対し、最も低いレベルは、PAI - 1 KOマウスで発見された。 <img src="/files/ftp_upload/2737/2737fig4.jpg" alt="図4" /> 血栓重量およびP -セレクチン可溶性の間に図4の相関は、異なる株で発見された。注目すべきは、短い血栓サイズを生成されたグループで、検出されたP -セレクチン可溶性（PAI - 1 KOマウス）最も低かった。最大の血栓サイズを生成したグループでは、検出されたP -セレクチン可溶性（凝固亢進デルタCT）最高であった。 <img src="/files/ftp_upload/2737/2737fig5.jpg" alt="図5" /> 図5：血流の存在を実証するためには、超音波がEIMを受けたマウスで行われた。図5は、2日EIM後にマウスで行われた超音波を示しています。その後、試料は収穫だった。血栓の形状が流れの存在下で血栓形成を示唆することに注意してください

<ol>
	<li>Diaz, J. A., Hawley, A. E., Alvarado, C. M. <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, 366-375 (2010).</li><li>Eitzman, D. T., Westrick, R. J., Nabel, 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=Plasminogen+activator+inhibitor-1+and+vitronectin+promote+vascular+thrombosis+in+mice.">Plasminogen activator inhibitor-1 and vitronectin promote vascular thrombosis in mice.</a> Blood. 95, 577-580 (2000).</li><li>Myers, D., Farris, D., Hawley, A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Selectins+influence+thrombosis+in+a+mouse+model+of+experimental+deep+venous+thrombosis.">Selectins influence thrombosis in a mouse model of experimental deep venous thrombosis.</a> J Surg Res. 108, 212-221 (2002).</li><li>Myers, D. D., Hawley, A. E., Farris, D. M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=P-selectin+and+leukocyte+microparticles+are+associated+with+venous+thrombogenesis.">P-selectin and leukocyte microparticles are associated with venous thrombogenesis.</a> J Vasc Surg. 38, 1075-1089 (2003).</li><li>Pierangeli, S. S., Barker, J. H., Stikovac, D. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Effect+of+human+IgG+antiphospholipid+antibodies+on+an+in+vivo+thrombosis+model+in+mice.">Effect of human IgG antiphospholipid antibodies on an in vivo thrombosis model in mice.</a> Thromb Haemost. 71, 670-674 (1994).</li><li>Pierangeli, S. S., Liu, X. W., Barker, J. H. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Induction+of+thrombosis+in+a+mouse+model+by+IgG,+IgM+and+IgA+immunoglobulins+from+patients+with+the+antiphospholipid+syndrome.">Induction of thrombosis in a mouse model by IgG, IgM and IgA immunoglobulins from patients with the antiphospholipid syndrome.</a> Thromb Haemost. 74, 1361-1367 (1995).</li></ol>

利害の衝突は宣言されません。

マウスは 、in vivo実験での優れた研究ツールです。このように、密接に疾患や病態を模倣するマウスモデルの開発が必要である。光化学（2）、うっ血（3-4）と機械的外傷（5-6）：いくつかの静脈血栓症のマウスモデルを含むDVTを研究するために使用されています。しかし、これらのモデルのどれも連続的な血流の存在下で血栓を生成するために内部内皮刺激を使用します。 EIMは、IVC内に電解刺激を使用して、血流の存在下で内皮活性化（1）で静脈血栓形成を促進する。それは簡単に再現可能な、技術的に簡単であり、高い生存率（99％）を持っています。電流が電解を作成するために使用されているという事実にもかかわらず、熱は、（1）生成されません。 EIMのモデルは密接に臨床DVTをシミュレートし、そのため血栓形成と解決の本質的なメカニズムを研究するための貴重なツールとして機能します。 EIMのモデルでは、血栓症の疾患に対する新しい治療法の進歩にも便利です。

<table border="1"><tbody><tr><th>試薬の名前</th><th>会社</th><th>カタログ番号</th><th>コメント（省略可能） </th></tr><tr><td> DMEM </td><td>インビトロジェン</td><td> ABCD1234 </td><td></td></tr></tbody></table>

electrolytic inferior vena cava model (eim) of venous thrombosis

動物モデルでは血栓形成、血栓溶解を研究するために、潜在的な治療用化合物（1）をテストするために、深部静脈血栓症（DVT）の研究において重要な役割を果たす。 DVTの治療と予防に利用される新たな化合物は、現在開発されている。影響を受ける血栓静脈への潜在的な治療アンタゴニスト化合物の配信が問題となっている。治療への応用の文脈では、部分的な停滞を使用し、一貫して主要な静脈内に血栓を生成するモデルは、最近設立されました。電解下大静脈モデル（EIM）は、連続的な血流の存在下で血栓形成を可能にDVTのマウスモデルです。このモデルでは、治療薬は、動的な方法で血栓と接触することができ、DVT（1）の他のモデルよりも敏感です。さらに、この血栓モデルは密接に血栓形成の臨床的な状況をシミュレートし、静脈内皮細胞の活性化、白血球遊走、静脈血栓、および治療への応用をテストする（1）を研究する理想的です。 EIMのモデルは簡単に​​再現可能な、技術的に簡単である、一貫性のある血栓の大きさを作成し、分析目的のために必要とされる大規模なサンプル（例：血栓と静脈の壁）が可能になります。

Watch this Scientific Journal Video about Electrolytic Inferior Vena Cava Model EIM of Venous Thrombosis at JoVE.com

Electrolytic Inferior Vena Cava Model EIM of Venous Thrombosis

内皮活性化と部分的な鬱血、ウィルヒョウの三つ組の二つの成分に起因する静脈型血栓形成における下大静脈の結果の内部表面に内皮活性化の電解誘導。

静脈血栓症の電解下大静脈モデル（EIM）

Animal models serve a vital role in deep venous thrombosis (DVT) research in order to study thrombus formation, thrombus resolution and to test potential ...

electrolytic-inferior-vena-cava-model-eim-of-venous-thrombosis

Research

JoVE Journal

Medicine

Electrolytic Inferior Vena Cava Model (EIM) of Venous Thrombosis

Mouse Complete Stasis Model of Inferior Vena Cava Thrombosis

Venous thromboembolism (VTE) includes both deep vein thrombosis (DVT) and pulmonary embolism (PE). In the United States (U.S.), the high morbidity and mortality rates make VTE a serious health concern 1-2. After heart disease and stroke, VTE is the third most common vascular disease 3. In the U.S. alone, there is an estimated 900,000 people affected each year, with 300,000 deaths occurring annually 3. A reliable in vivo animal model to study the mechanisms of this disease is necessary.
The advantages of using the mouse complete stasis model of inferior vena cava thrombosis are several. The mouse model allows for the administration of very small volumes of limited availability test agents, reducing costs dramatically. Most promising is the potential for mice with gene knockouts that allow specific inflammatory and coagulation factor functions to be delineated. Current molecular assays allow for the quantitation of vein wall, thrombus, whole blood, and plasma for assays. However, a major concern involving this model is the operative size constraints and the friability of the vessels. Also, due to the small IVC sample weight (mean 0.005 grams) it is necessary to increase animal numbers for accurate statistical analysis for tissue, thrombus, and blood assays such as real-time polymerase chain reaction (RT-PCR), western blot, enzyme-linked immunosorbent (ELISA), zymography, vein wall and thrombus cellular analysis, and whole blood and plasma assays 4-8.
The major disadvantage with the stasis model is that the lack of blood flow inhibits the maximal effect of administered systemic therapeutic agents on the thrombus and vein wall.

The mouse complete stasis model of inferior vena cava thrombosis yields quantifiable amounts of vein wall tissue and thrombus. It has proven useful for evaluating interactions between the vein wall and the occlusive thrombus and in assessing the progression from acute to chronic inflammation.

下大静脈血栓症のマウス完全な停滞のモデル

Venous thromboembolism (VTE) includes both deep vein thrombosis (DVT) and pulmonary embolism (PE).  In the United States (U.S.), the high morbidity and ...

医学

Implantation of Inferior Vena Cava Interposition Graft in Mouse Model

Biodegradable scaffolds seeded with bone marrow mononuclear cells (BMCs) are often used for reconstructive surgery to treat congenital cardiac anomalies. The long-term clinical results showed excellent patency rates, however, with significant incidence of stenosis. To investigate the cellular and molecular mechanisms of vascular neotissue formation and prevent stenosis development in tissue engineered vascular grafts (TEVGs), we developed a mouse model of the graft with approximately 1 mm internal diameter. First, the TEVGs were assembled from biodegradable tubular scaffolds fabricated from a polyglycolic acid nonwoven felt mesh coated with &#949;-caprolactone and L-lactide copolymer. The scaffolds were then placed in a lyophilizer, vacuumed for 24 hr, and stored in a desiccator until cell seeding. Second, bone marrow was collected from donor mice and mononuclear cells were isolated by density gradient centrifugation. Third, approximately one million cells were seeded on a scaffold and incubated O/N. Finally, the seeded scaffolds were then implanted as infrarenal vena cava interposition grafts in C57BL/6 mice. The implanted grafts demonstrated excellent patency (&#62;90%) without evidence of thromboembolic complications or aneurysmal formation. This murine model will aid us in understanding and quantifying the cellular and molecular mechanisms of neotissue formation in the TEVG.

To improve our knowledge of cellular and molecular neotissue formation, a murine model of the TEVG was recently developed. The grafts were implanted as infrarenal vena cava interposition grafts in C57BL/6 mice. This model achieves similar results to those achieved in our clinical investigation, but over a far shortened time-course.

マウスモデルにおける下大静脈介在移植の移植

Biodegradable scaffolds seeded with bone marrow mononuclear cells (BMCs) are often used for reconstructive surgery to treat congenital cardiac anomalies. ...

Ferric Chloride-induced Thrombosis Mouse Model on Carotid Artery and Mesentery Vessel

Severe thrombosis and its ischemic consequences such as myocardial infarction, pulmonary embolism and stroke are major worldwide health issues. The ferric chloride injury is now a well-established technique to rapidly and accurately induce the formation of thrombi in exposed veins or artery of small and large diameter. This model has played a key role in the study of the pathophysiology of thrombosis, in the discovery and validation of novel antithrombotic drugs and in the understanding of the mechanism of action of these new agents. Here, the implementation of this technique on a mesenteric vessel and carotid artery in mice is presented. The method describes how to label circulating leukocytes and platelets with a fluorescent dye and to observe, by intravital microscopy on the exposed mesentery, their accumulation at the injured vessel wall which leads to the formation of a thrombus. On the carotid artery, the occlusion caused by the clot formation is measured by monitoring the blood flow with a Doppler probe.

The FeCl3 induced thrombosis model in mice is described herein. A method to monitor thrombus growth by intravital microscopy observation on a mesenteric vessel and by blood flow measurement in the carotid artery is presented.

塩化第二鉄誘発性頚動脈および腸間膜血管に血栓症のマウスモデル

Severe thrombosis and its ischemic consequences such as myocardial infarction, pulmonary embolism and stroke are major worldwide health issues. The ferric ...

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.

ラット大動脈または下大静脈内のパッチ血管形成術

Pericardial patches are commonly used in vascular surgery to close vessels. To facilitate studies of the neointimal hyperplasia that forms on the patch, ...

A Rat Model of Orthotopic Liver Transplantation Using a Novel Magnetic Anastomosis Technique for Suprahepatic Vena Cava Reconstruction

The rat model of orthotopic liver transplantation (OLT) is essential for transplant research. It is a very sophisticated animal model and requires a steep learning curve. The introduction of the cuff technique for anastomosis of the portal vein (PV) and infrahepatic vena cava (IHVC) has significantly simplified the transplant procedure in rats. However, due to the short anterior wall of the recipients' suprahepatic vena cava (SHVC), the cuff technique is very difficult to use for the reconstruction of the SHVC. Most researchers in this field still use the hand-suture technique for SHVC reconstruction, which makes it the bottleneck step in rat orthotopic liver transplantation. The magnetic anastomosis technique (i.e., magnamosis) is a method of connecting two vessels using the attractive force between two magnets. Our recent study has shown that the magnetic anastomosis technique is superior to the hand-suture technique for SHVC reconstruction in rats. In this article, we show a step-by-step protocol for SHVC reconstruction in rats using the novel magnetic anastomosis technique. In this model, the reconstruction of the PV and IHVC was performed by the standard cuff technique, while the reconstruction of the bile duct (BD) was performed by a stent technique. The hepatic re-arterialization was not performed. The magnetic anastomosis technique made SHVC reconstruction much easier and significantly shortened the anphepatic phase. After a reasonable learning curve, even researchers without advanced microsurgical skills can produce reliable and reproducible results using this rat model of OLT.

The reconstruction of the suprahepatic vena cava (SHVC) remains a difficult step in rat orthotopic liver transplantation. In this article, we show a step-by-step protocol for SHVC reconstruction in rats using a novel magnetic anastomosis technique.

同所性同種のモデルラット Suprahepatic 上大静脈再建のため新規磁気吻合法を用いた肝移植

The rat model of orthotopic liver transplantation (OLT) is essential for transplant research. It is a very sophisticated animal model and requires a steep ...

Ferric Chloride-induced Canine Carotid Artery Thrombosis: A Large Animal Model of Vascular Injury

Occlusive arterial thrombosis leading to cerebral ischemic stroke and myocardial infarction contributes to ~13 million deaths every year globally. Here, we have translated a vascular injury model from a small animal into a large animal (canine), with slight modifications that can be used for pre-clinical screening of prophylactic and thrombolytic agents. In addition to the surgical methods, the modified protocol describes the step-by-step methods to assess carotid artery canalization by angiography, detailed instructions to process both the brain and carotid artery for histological analysis to verify carotid canalization and cerebral hemorrhage, and specific parameters to complete an assessment of downstream thromboembolic events by utilizing magnetic resonance imaging (MRI). In addition, specific procedural changes from the previously well-established small animal model necessary to translate into a large animal (canine) vascular injury are discussed.

Here, we present the modifications necessary to a well characterized and commonly used small animal ferric chloride-induced (FeCl3) carotid artery injury model for use in a large animal vascular injury model. The resulting model can be utilized for pre-clinical trial assessment of both prophylactic and thrombolytic pharmacological and mechanical interventions.

塩化第二鉄によるイヌ総頚動脈血栓症: 血管損傷の大動物モデル

Occlusive arterial thrombosis leading to cerebral ischemic stroke and myocardial infarction contributes to ~13 million deaths every year globally. Here, ...

Isometric Contractility Measurement of the Mouse Mesenteric Artery Using Wire Myography

The wire myograph technique is used to assess the contractility of vascular smooth muscles in response to depolarization, GPCR agonists/inhibitors and drugs. It is widely used in many studies on the physiological functions of vascular smooth muscle, the pathogenesis of vascular diseases such as hypertension, and the development of smooth muscle relaxant drugs. The mouse is a widely used model animal with a large pool of disease models and genetically modified strains. We introduced this method to measure the isometric contraction of mouse mesenteric artery in detail. A 1.4-mm segment of mouse mesenteric resistance artery was isolated and mounted on a myograph chamber by passing two steel wires through its lumen. After equilibration and normalization steps, the vessel segment was potentiated by a high-K+ solution twice prior to the contraction assay. As an example of the application of this method in drug development, we measured the relaxant effect of a novel natural substance, neoliensinine, isolated from a Chinese herb, embryos of the lotus seed (Nelumbo nucifera Gaertn.) on mouse mesenteric arteries. The vessel segments mounted on the myograph chamber were stimulated with a high-K+ solution. When the force tension reached a stable sustained phase, cumulative doses of neoliensinine were added to the chamber. We found that neoliensinine had a dose-dependent relaxant effect on smooth muscle contraction, thus suggesting that it bears potential activity against hypertension. In addition, as the vessel segment can survive at least 4 hours after mounting and maintain contractility induced by the high-K+ solution for many times, we suggest that the wire myograph system may be used for the time-consuming process of drug screening.

The wire myograph technique is used to investigate vascular smooth muscle functions and screen new drugs. We report a detailed protocol for measuring the isometric contractility of the mouse mesenteric artery and for screening new relaxants of vascular smooth muscle.

ワイヤー図法を使用してマウスの腸間膜動脈の等尺性収縮力測定

The wire myograph technique is used to assess the contractility of vascular smooth muscles in response to depolarization, GPCR agonists/inhibitors and ...

Murine Model of Central Venous Stenosis using Aortocaval Fistula with an Outflow Stenosis

Central venous stenosis is an important entity contributing to arteriovenous fistula (AVF) failure. A murine AVF model was modified to create a partial ligation of the inferior vena cava (IVC) in the outflow of the fistula, mimicking central venous stenosis. Technical aspects of this model are introduced. The aorta and IVC are exposed, following an abdominal incision. The infra-renal aorta and IVC are dissected for proximal clamping, and the distal aorta is exposed for puncture. The IVC at the midpoint between the left renal vein and the aortic bifurcation is carefully dissected to place an 8-0 suture beneath the IVC. After clamping the aorta and IVC, an AVF is created by puncturing the infra-renal aorta through both walls into the IVC with a 25 G needle, followed by ligating a 22 G intra-venous (IV) catheter and IVC together. The catheter is then removed, creating a reproducible venous stenosis without occlusion. The aorta and IVC are unclamped after confirming primary hemostasis. This novel model of central vein stenosis is easy to perform, reproducible, and will facilitate studies on AVF failure.

An aortocaval fistula was created by puncturing the murine infra-renal aorta through both walls into the inferior vena cava and was followed by creation of a stenosis in its outflow via partial ligation of the inferior vena cava. This reproducible model can be used to study central venous stenosis.

流出狭窄を伴う大軌道瘻を用した中枢静脈狭窄のマウスモデル

Central venous stenosis is an important entity contributing to arteriovenous fistula (AVF) failure. A murine AVF model was modified to create a partial ...

Image Acquisition Method for the Sonographic Assessment of the Inferior Vena Cava

Over the past several decades, clinicians have incorporated several applications of diagnostic point-of-care ultrasound (POCUS) into medical decision-making. Among the applications of POCUS, imaging the inferior vena cava (IVC) is practiced by a wide variety of specialties, such as nephrology, emergency medicine, internal medicine, critical care, anesthesiology, pulmonology, and cardiology. Although each specialty uses IVC data in slightly different ways, most medical specialties, at minimum, attempt to use IVC data to make predictions about intravascular volume status. While the relationship between IVC sonographic data and intravascular volume status is complex and highly context-dependent, all clinicians should collect the sonographic data in standardized ways to ensure repeatability. This paper describes standardized IVC image acquisition including patient positioning, transducer selection, probe placement, image optimization, and the pitfalls and limitations of IVC sonographic imaging.&#160;This paper also describes the commonly performed anterior IVC long-axis view and three other views of the IVC that can each provide helpful diagnostic information when the anterior long-axis view is difficult to obtain or interpret.

Point-of-care ultrasound evaluation of the inferior vena cava (IVC) is commonly utilized to identify, among other things, the volume status. Imaging should be performed systematically to ensure repeatability. This manuscript reviews the methods and pitfalls of sonographic IVC examination.

下大静脈の超音波評価のための画像取得方法

Over the past several decades, clinicians have incorporated several applications of diagnostic point-of-care ultrasound (POCUS) into medical ...

Point-Of-Care Ultrasound Screening for Proximal Lower Extremity Deep Venous Thrombosis

Acute lower extremity deep venous thrombosis (DVT) is a serious vascular disorder that requires accurate and early diagnosis to prevent life-threatening sequelae. While whole leg compression ultrasound with color and spectral Doppler is commonly performed in radiology and vascular labs, point-of-care ultrasound (POCUS) is becoming more common in the acute care setting. Providers appropriately trained in focused POCUS can perform a rapid bedside examination with high sensitivity and specificity in critically ill patients. This paper describes a simplified yet validated approach to POCUS by describing a three-zone protocol for lower extremity DVT POCUS image acquisition. The protocol explains the steps in obtaining vascular images at six compression points in the lower extremity. Beginning at the level of the proximal thigh and moving distally to the popliteal space, the protocol guides the user through each of the compression points in a stepwise manner: from the common femoral vein to the femoral and deep femoral vein bifurcation, and, finally, to the popliteal vein. Further, a visual aid is provided that may assist providers during real-time image acquisition. The goal in presenting this protocol is to help make proximal lower extremity DVT exams more accessible and efficient for POCUS users at the patient&#39;s bedside.

Traditionally, lower extremity deep venous thrombosis (DVT) is diagnosed by radiology-performed venous duplex ultrasound. Providers appropriately trained in focused point-of-care ultrasound (POCUS) can perform a rapid bedside examination with high sensitivity and specificity in critically ill patients. We describe the scanning technique for focused POCUS DVT lower extremity examination.

近位下肢深部静脈血栓症のためのポイントオブケア超音波スクリーニング

Acute lower extremity deep venous thrombosis (DVT) is a serious vascular disorder that requires accurate and early diagnosis to prevent life-threatening ...