Name: arterial pouch microsurgical bifurcation aneurysm model in the rabbit
Uploaded: 2020-05-14T13:00:00
Description: Watch this Scientific Journal Video about Arterial Pouch Microsurgical Bifurcation Aneurysm Model in the Rabbit at JoVE.com

The authors thank Olgica Beslac and Kay Nettelbeck for their excellent support and technical assistance during the peri-operative phase and Alessandra Bergadano, DVM, PhD, for the dedicated supervision of the long-term animal health.

All veterinary care was performed in accordance with the institutional guidelines (all experiments were approved by the Local Committee for Animal Care of the Canton Bern, Switzerland (BE 108/16)) and conducted under supervision of a board-certified veterinarian anesthesiologist. The ARRIVE guidelines and the 3R principles were strictly followed17,18.
NOTE: House all animals at a room temperature of 22&#8210;24 Celsius (&#176;C)&#160;a...

Our study demonstrates the feasibility of creating a true bifurcation aneurysm model with different wall conditions in rabbits. Overall, 14 female New Zealand White rabbits with a mean weight of 3.7 &#177; 0.09 kg and mean age of 112 &#177; 3 days were included in the study. 85.72% of all aneurysms remained patent during a follow-up at 28 days. Two animals died prematurely (12.5% mortality).
Previous studies suggested a variety of extracranial aneurysm models to analyze the management of endov...

Subarachnoid hemorrhage resulting from intracranial aneurysm (IA) rupture&#160;can effectively be controlled by either endovascular or microsurgical occlusion techniques1,2,3,4. Different endovascular therapies, to overcome the main limitation of IA recurrence after coiling, gained importance over the past decades generating an increased need of testing endovascular devices. To test these novel treatment approaches, appropriate animal models that respect rheological properties, hemodynamics and aneurysm wall conditions are highly warranted5,6,7. In this context, clinical as well as preclinical studies have already revealed the important role of aneurysm wall conditions regarding aneurysm rupture and recurrence after occlusion, especially focusing on the loss of mural cells7,8,9.
So far, experimental aneurysms in rabbits have most often been created either by elastase incubated common carotid artery (CCA) stumps or venous pouches sutured into an artificial CCA bifurcation.10,11,12,13,14,15,16 Thus, a true arterial pouch bifurcation model has never been described.
The aim of this study was to design a safe, fast, and standardized technique for microsurgical creation of bifurcation aneurysms with different wall conditions in a rabbit model (Figure 1). This was achieved by suturing non-modified and modified arterial pouches into an artificial created bifurcation of both CCAs.

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			<td>3-0 resorbable suture</td>
			<td>Ethicon Inc., USA</td>
			<td>VCP428G</td>
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			<td>4-0 non-absorbable suture</td>
			<td>B. Braun, Germany</td>
			<td>G0762563</td>
			<td></td>
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			<td>6-0 non-absorbable suture</td>
			<td>B. Braun, Germany</td>
			<td>C0766070</td>
			<td></td>
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			<td>9-0 non-absorbable suture</td>
			<td>B. Braun, Germany</td>
			<td>G1111140</td>
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			<td>Adrenaline</td>
			<td>Amino AG</td>
			<td>1445419</td>
			<td>any generic</td>
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			<td>Amiodarone</td>
			<td>Helvepharm AG</td>
			<td>5078567</td>
			<td>any generic</td>
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			<td>Anesthesia machine</td>
			<td>Dr&#228;ger</td>
			<td></td>
			<td>any other</td>
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			<td>Aspirin</td>
			<td>Sanofi-Aventis (Suisse) SA</td>
			<td>622693</td>
			<td>any generic</td>
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			<td>Atropine</td>
			<td>Labatec Pharma SA</td>
			<td>6577083</td>
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			<td>Thorlabs</td>
			<td>FD1B</td>
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			<td>Thorlabs</td>
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			<td>Bicycle spotlight</td>
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			<td>Biemer vessel clip (2 x)</td>
			<td>B. Braun Medical AG, Aesculap, Switzerland</td>
			<td>FD560R</td>
			<td>temporary</td>
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			<td>Bispectral index (neonatal)</td>
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			<td>Blood pressure cuff (neonatal)</td>
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			<td>any other</td>
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			<td>Clamoxyl</td>
			<td>GlaxoSmithKline AG</td>
			<td>758808</td>
			<td>any generic</td>
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			<td>Dexmedetomidine</td>
			<td>Ever Pharma</td>
			<td>136740-1</td>
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			<td>Electrocardiogram electrodes</td>
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			<td>Elastase</td>
			<td>Sigma Aldrich</td>
			<td>45125</td>
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			<td>Ephedrine</td>
			<td>Amino AG</td>
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			<td>Esmolol</td>
			<td>OrPha Swiss GmbH</td>
			<td>3284044</td>
			<td>any generic</td>
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			<td>Fentanyl (intravenous use)</td>
			<td>Janssen-Cilag AG</td>
			<td>98683</td>
			<td>any generic</td>
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			<td>Fentanyl (transdermal)</td>
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			<td>Fragmin</td>
			<td>Pfizer PFE Switzerland GmbH</td>
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			<td>Glyco</td>
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			<td>Heating pad</td>
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			<td>any other</td>
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			<td>Isotonic sodium chloride solution (0.9%)</td>
			<td>Fresenius KABI</td>
			<td>336769</td>
			<td>any generic</td>
		</tr>
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			<td>Ketamine</td>
			<td>Pfizer</td>
			<td>342261</td>
			<td>any generic</td>
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			<td>Laboratory shaker</td>
			<td>Stuart</td>
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			<td>Streuli Pharma AG</td>
			<td>747466</td>
			<td>any generic</td>
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			<td>Longuettes</td>
			<td></td>
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			<td>any other</td>
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			<td>Metacam</td>
			<td>Boehringer Ingelheim</td>
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			<td>any generic</td>
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			<td>Methadone</td>
			<td>Streuli Pharma AG</td>
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			<td>Microtubes</td>
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			<td>any other</td>
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			<td>Midazolam</td>
			<td>Accord Healthcare AG</td>
			<td>7752484</td>
			<td>any generic</td>
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			<td>Needle holder</td>
			<td></td>
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			<td>any other</td>
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			<td>O2-Face mask</td>
			<td></td>
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			<td>any other</td>
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			<td>Operation microscope</td>
			<td>Wild Heerbrugg</td>
			<td></td>
			<td>any other</td>
		</tr>
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			<td>Papaverine</td>
			<td>Bichsel</td>
			<td></td>
			<td>any generic</td>
		</tr>
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			<td>Prilocaine-lidocaine creme</td>
			<td>Emla</td>
			<td></td>
			<td>any generic</td>
		</tr>
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			<td>Propofol</td>
			<td>B. Braun Medical AG, Switzerland</td>
			<td></td>
			<td>any generic</td>
		</tr>
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			<td>Pulse oxymeter</td>
			<td></td>
			<td></td>
			<td>any generic</td>
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			<td>Rectal temperature probe (neonatal)</td>
			<td></td>
			<td></td>
			<td>any other</td>
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			<td>Ropivacaine</td>
			<td>Aspen Pharma Schweiz GmbH</td>
			<td>1882249</td>
			<td>any generic</td>
		</tr>
		<tr>
			<td>Scalpell</td>
			<td>Swann-Morton</td>
			<td>210</td>
			<td>any other</td>
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			<td>Small animal shaver</td>
			<td></td>
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			<td>any other</td>
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			<td>Smartphone</td>
			<td></td>
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			<td>any other</td>
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			<td>Soft tissue forceps</td>
			<td></td>
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			<td>any other</td>
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			<td>Soft tissue spreader</td>
			<td></td>
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			<td>any other</td>
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			<td>Stainless steel sponge bowls</td>
			<td></td>
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			<td>any other</td>
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			<td>Sterile micro swabs</td>
			<td></td>
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			<td>any other</td>
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			<td>Stethoscope</td>
			<td></td>
			<td></td>
			<td>any other</td>
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			<td>Straight and curved micro-forceps</td>
			<td></td>
			<td></td>
			<td>any other</td>
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			<td>Straight and curved micro-scissors</td>
			<td></td>
			<td></td>
			<td>any other</td>
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		<tr>
			<td>Straight and curved forceps</td>
			<td></td>
			<td></td>
			<td>any other</td>
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		<tr>
			<td>Surgery drape</td>
			<td></td>
			<td></td>
			<td>any other</td>
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		<tr>
			<td>Surgical scissors</td>
			<td></td>
			<td></td>
			<td>any other</td>
		</tr>
		<tr>
			<td>Syringes 1 ml, 2ml and 5 ml</td>
			<td></td>
			<td></td>
			<td>any other</td>
		</tr>
		<tr>
			<td>Tris-Buffer</td>
			<td>Sigma Aldrich</td>
			<td>93302</td>
			<td>any generic</td>
		</tr>
		<tr>
			<td>Vascular clip applicator</td>
			<td>B. Braun, Germany</td>
			<td>FT495T</td>
			<td></td>
		</tr>
		<tr>
			<td>Vein and arterial catheter 22 G</td>
			<td></td>
			<td></td>
			<td>any generic</td>
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			<td>Vitarubin</td>
			<td>Streuli Pharma AG</td>
			<td>6847559</td>
			<td>any generic</td>
		</tr>
		<tr>
			<td>Yasargil titan standard clip (2 x)</td>
			<td>B. Braun Medical AG, Aesculap, Switzerland</td>
			<td>FT242T</td>
			<td>temporary</td>
		</tr>
	</tbody>
</table>

arterial pouch microsurgical bifurcation aneurysm model in the rabbit

Endovascular treatment for intracranial aneurysms gained importance over the past decades, consequently there is an increased need of testing endovascular devices. Animal models respecting rheological, hemodynamic and aneurysm wall conditions are highly warranted. Therefore, the aim of the present study was to design a novel standardized and reproducible surgical technique to create autologous arterial pouch bifurcation aneurysms with non-modified and modified wall conditions in rabbits.
Bifurcation aneurysms were created by end-to-side anastomosis of the right on the left common carotid artery, both serving as parent arteries for the arterial pouch, which was microsurgically sewn on. Grafts were taken from the proximal right common carotid artery, either for the control (n = 7, immediate autologous re-implantation) or modified (n = 7, incubated with 100 international units elastase for 20 minutes before autologous re-implantation) group. Pouch and parent artery patency were controlled by fluorescence angiography immediately after creation. At follow-up (28 days), all rabbits underwent contrast enhanced magnetic resonance angiography and fluorescence angiography followed by aneurysm harvesting, macroscopic and histological evaluation.
A total of 16 female New Zealand White rabbits were operated upon. Two animals died prematurely. At follow-up, 85.72% of all aneurysms remained patent. Both groups revealed an increase in aneurysm size over time; this was more pronounced in the control group (6.48 &#177; 1.81 mm3 at time of creation vs. 19.85 &#177; 6.40 mm3 at follow-up, p = 0.037) than in the modified group (8.03 &#177; 1.08 mm3 at time of creation vs. 20.29 &#177; 6.16 mm3 at follow-up, p = 0.054).
Our findings demonstrate the adequacy of this new rabbit model which allows for the creation of bifurcation aneurysms with different wall conditions in a microsurgical approach. Given the excellent long-term patency and the property of aneurysm growth over time, this model may serve as an important tool for preclinical evaluation of novel endovascular therapies.

Following a pilot series of seven animals, totally 16 animals were included in the experimental protocol. Two animals died prematurely and were therefore excluded from the final analysis (12.5% mortality). Calculated on 14 animals, immediate aneurysm patency rate during fluorescence angiography was 71.43% in both, the control and modified group. Four aneurysms had to be reopened with consecutive thrombus evacuation and after a repeated fluorescence angiography there was a documented patency in all cases (100%). Aneurysm ...

Watch this Scientific Journal Video about Arterial Pouch Microsurgical Bifurcation Aneurysm Model in the Rabbit at JoVE.com

Arterial Pouch Microsurgical Bifurcation Aneurysm Model in the Rabbit

Developing and testing endovascular devices for intracranial aneurysm treatment is still of great importance. Most aneurysm models used today miss either the important characteristics of an arterial degenerated wall or the hemodynamics of a true bifurcation. Therefore, we aimed to design a novel arterial pouch bifurcation model in rabbits.

Endovascular treatment for intracranial aneurysms gained importance over the past decades, consequently there is an increased need of testing endovascular ...

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