Name: Pleins feux sur l’auteur : Utilisation d’un modèle de ballonnet de venénoplastie chez les rongeurs pour simuler des interventions chirurgicales pour les veines profondes
Uploaded: 2024-05-24T14:30:00
Description: Balloon venoplasty is a commonly used clinical technique to treat deep vein stenosis and occlusion as a consequence of trauma, congenital anatomic ...

Cette étude est soutenue par la subvention de recherche en sciences fondamentales 2023 de l’American Venous Forum (AVF) et Surmodics, Inc.

Le protocole suivant suit les politiques et les directives de l’Institutional Animal Care and Use Committee (IACUC) de l’Université du Michigan (UMICH), les principes du gouvernement américain pour l’utilisation et le soin des animaux vertébrés utilisés dans les tests, la recherche et la formation, et les directives ARRIVE 2.0. L’accord d’assurance du bien-être animal de l’UMICH est conforme aux normes OLAW et USDA et est entièrement accrédité par AAALAC International. Ce protocole a été approuvé ...

Modèle de ballonnet de venoplastie de rongeur pour les études de traitement des veines profondes

<ol>
	<li>Prandoni, P., 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=The+long-term+clinical+course+of+acute+deep+venous+thrombosis.">The long-term clinical course of acute deep venous thrombosis.</a> Ann Inter Med. 125 (1), 1-7 (1996).</li><li>Prandoni, P., Kahn, S. R. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Post-thrombotic+syndrome:+prevalence,+prognostication+and+need+for+progress.">Post-thrombotic syndrome: prevalence, prognostication and need for progress.</a> Br J Haematol. 145 (3), 286-295 (2009).</li><li>Gloviczki, P., 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=The+2023+Society+for+Vascular+Surgery,+American+Venous+Forum,+and+American+Vein+and+Lymphatic+Society+clinical+practice+guidelines+for+the+management+of+varicose+veins+of+the+lower+extremities.+Part+II.">The 2023 Society for Vascular Surgery, American Venous Forum, and American Vein and Lymphatic Society clinical practice guidelines for the management of varicose veins of the lower extremities. Part II.</a> J Vas Surg Venous Lymph Diso. 12 (1), 101670 (2024).</li><li>Henke, P., Sharma, S., Wakefield, T., Myers, D., Obi, A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Insights+from+experimental+post-thrombotic+syndrome+and+potential+for+novel+therapies.">Insights from experimental post-thrombotic syndrome and potential for novel therapies.</a> Transl Res. 225, 95-104 (2020).</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=Choosing+a+mouse+model+of+venous+thrombosis:+A+consensus+assessment+of+utility+and+application.">Choosing a mouse model of venous thrombosis: A consensus assessment of utility and application.</a> Arterioscl Thrombo Vasc Biol. 39 (3), 311-318 (2019).</li><li>Lee, Y. U., Lee, A. Y., Humphrey, J. D., Rausch, M. K. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Histological+and+biomechanical+changes+in+a+mouse+model+of+venous+thrombus+remodeling.">Histological and biomechanical changes in a mouse model of venous thrombus remodeling.</a> Biorheology. 52 (3), 235-245 (2015).</li><li>Xie, 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=Correspondence+of+ultrasound+elasticity+imaging+to+direct+mechanical+measurement+in+aging+DVT+in+rats.">Correspondence of ultrasound elasticity imaging to direct mechanical measurement in aging DVT in rats.</a> Ultrasound Med Biol. 31 (10), 1351-1359 (2005).</li><li>Moini, 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=Venoplasty+and+stenting+in+post-thrombotic+syndrome+and+non-thrombotic+iliac+vein+lesion.">Venoplasty and stenting in post-thrombotic syndrome and non-thrombotic iliac vein lesion.</a> Minim Invasive Ther Allied Technol. 29 (1), 35-41 (2020).</li><li>Chaitidis, 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=Management+of+post-thrombotic+syndrome:+A+comprehensive+review.">Management of post-thrombotic syndrome: A comprehensive review.</a> Curr Pharma Des. 28 (7), 550-559 (2022).</li><li>Dangas, G. 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=In-stent+restenosis+in+the+drug-eluting+stent+era.">In-stent restenosis in the drug-eluting stent era.</a> J Am Coll Cardiol. 56 (23), 1897-1907 (2010).</li><li>Negl&#233;n, P., Berry, M. A., Raju, S. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Endovascular+surgery+in+the+treatment+of+chronic+primary+and+post-thrombotic+iliac+vein+obstruction.">Endovascular surgery in the treatment of chronic primary and post-thrombotic iliac vein obstruction.</a> Euro J Vas Endovas Surg. 20 (6), 560-571 (2000).</li><li>Sharifi, M., Mehdipour, M., Bay, C., Smith, G., Sharifi, J. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Endovenous+therapy+for+deep+venous+thrombosis:+The+TORPEDO+trial.">Endovenous therapy for deep venous thrombosis: The TORPEDO trial.</a> Catheter Cardiovasc Interv. 76 (3), 316-325 (2010).</li><li>Nicklas, J. M., Gordon, A. E., Henke, P. K. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Resolution+of+deep+venous+thrombosis:+Proposed+immune+paradigms.">Resolution of deep venous thrombosis: Proposed immune paradigms.</a> Int J Mol Sci. 21 (6), 2080 (2020).</li><li>Li, J., Kim, S. G., Blenis, J. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Rapamycin:+One+drug,+many+effects.">Rapamycin: One drug, many effects.</a> Cell Metabol. 19 (3), 373-379 (2014).</li><li>Chen, X., 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=Rapamycin+regulates+Akt+and+ERK+phosphorylation+through+mTORC1+and+mTORC2+signaling+pathways.">Rapamycin regulates Akt and ERK phosphorylation through mTORC1 and mTORC2 signaling pathways.</a> Mol Carcinogen. 49 (6), 603-610 (2010).</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 Haemo. 13 (4), 660-664 (2015).</li><li>Sch&#246;nfelder, T., J&#228;ckel, S., Wenzel, P. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Mouse+models+of+deep+vein+thrombosis.">Mouse models of deep vein thrombosis.</a> Gef&#228;sschirurgie. 22 (1), 28-33 (2017).</li><li>de Barros, R. S. 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=Morphometric+analysis+of+rat+femoral+vessels+under+a+video+magnification+system.">Morphometric analysis of rat femoral vessels under a video magnification system.</a> J Vasc Bras. 16 (1), 73-76 (2017).</li></ol>

Le VBM peut être effectué sur des rats ≥ 250 g à l’aide de ballons de 2,5 à 3,5 mm. Pour les rats dépassant 750 g, la technique est limitée par une plus grande quantité de tissu adipeux dans la cavité abdominale et la taille des organes plutôt que par des changements dans le diamètre de la VCI. D’après notre expérience, nous avons constaté qu’il faut 10 animaux ou plus par groupe pour obtenir une signification statistique entre les groupes pour l’analyse des protéines de la paroi veineuse ou les t...

Les obstructions veineuses profondes dues à des thrombus non résolus sont une conséquence fréquente de la thrombose veineuse profonde (TVP) et sont l’une des causes du syndrome post-thrombotique (SPT), coûtant des milliards de dollars en soins de santé et ayant un impact significatif sur la qualité devie1,2,3. Le SPT est une pathologie inflammatoire unique avec une fibrose de la paroi veineuse4 qui n’est pas entièrement capturée dans les modèles de TVP chez les petits animaux 5,6,7, et plus important encore, les modèles précédents ne peuvent pas évaluer la réponse aux interventions thérapeutiques. Les obstructions veineuses thrombotiques sont souvent traitées par une endoprothèse et une veinoplastie par ballonnet 8,9 ; De telles interventions sont entravées par un taux élevé de réintervention dû à la resténose et à l’occlusion 10,11,12.
Malgré la disponibilité de ballons enrobés de médicament pour traiter les sténoses/occlusions spécifiques aux artères, il n’en existe aucun pour les veines profondes. Le mécanisme moléculaire de la resténose est mal compris dans les veines et n’a pas de traitement direct4. Par conséquent, notre objectif est de présenter un modèle animal capable de tester des thérapies délivrées localement via des ballonnets de veinoplastie simulant des obstructions post-thrombotiques veineuses profondes. Ce modèle reproduit l’état post-thrombotique et évalue comment différents types de ballons de veinoplastie affectent la paroi veineuse in vivo.

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			<td>3-0 DemeCRYL</td>
			<td>DemeTech</td>
			<td>G183019F4P</td>
			<td>12 per box</td>
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			<td>5-0 DemeCRYL</td>
			<td>DemeTech</td>
			<td>G285017B0P</td>
			<td>12 per box</td>
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			<td>7-0 DemeLENE</td>
			<td>DemeTech</td>
			<td>PM197011F13M</td>
			<td>12 per box</td>
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			<td>8-0 DemeLON</td>
			<td>DemeTech</td>
			<td>NL868007C7P</td>
			<td>12 per box</td>
		</tr>
		<tr>
			<td>Angled Clip Applier</td>
			<td>SCANLAN</td>
			<td>3795-01A</td>
			<td>7-1/4&#8243; (18.5 cm)</td>
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			<td>Baxter 0.9% Sodium Chloride Irrigation Bottle</td>
			<td>Baxter</td>
			<td>SKU: 195-7124</td>
			<td>1000mL Bottle</td>
		</tr>
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			<td>Bovie Cautery Low Temperature Fine Tip</td>
			<td>Symmetry Surgical Inc</td>
			<td>AA00</td>
			<td>10/bx</td>
		</tr>
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			<td>Buprenorphine</td>
			<td>Fidelis Animal Health</td>
			<td>SKU- 099114</td>
			<td>1.3mg/mL, 3mL</td>
		</tr>
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			<td>CD (Sprague Dawley) Rats</td>
			<td>Charles River</td>
			<td>Strain Code 001</td>
			<td>Male, 400 gm</td>
		</tr>
		<tr>
			<td>Clip-It Traceable Timer</td>
			<td>TRACEABLE PRODUCTS</td>
			<td>Cat. No. 5046</td>
			<td></td>
		</tr>
		<tr>
			<td>Cotton-Tip Applicator 3&#34;</td>
			<td>Dukal Corporation</td>
			<td>922-00037BX100</td>
			<td>1000/BOX</td>
		</tr>
		<tr>
			<td>Enzymatic Surgical Instrument Detergent and Presoak</td>
			<td>Medline</td>
			<td>MDS88000B9</td>
			<td>1 Gal</td>
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			<td>Eye Lube</td>
			<td>Optixcare</td>
			<td>SKU-065441</td>
			<td>20gm&#160;</td>
		</tr>
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			<td>Gaymar T/Pump Stryker Localized Warming/Cooling Therapy System</td>
			<td>Stryker</td>
			<td>TP700</td>
			<td></td>
		</tr>
		<tr>
			<td>Heifetz Microclips 12mmx2.25mm</td>
			<td>SCANLAN</td>
			<td>3795-20</td>
			<td>Straight</td>
		</tr>
		<tr>
			<td>Heifetz Microclips 12mmx2.25mm</td>
			<td>SCANLAN</td>
			<td>3795-28</td>
			<td>Curved</td>
		</tr>
		<tr>
			<td>Heifetz Microclips 8mmx1.75mm&#160;</td>
			<td>SCANLAN</td>
			<td>3795-14</td>
			<td>Straight</td>
		</tr>
		<tr>
			<td>Heifetz Microclips 8mmx1.75mm&#160;</td>
			<td>SCANLAN</td>
			<td>3795-18</td>
			<td>Curved</td>
		</tr>
		<tr>
			<td>Inflation device&#160;</td>
			<td>Merit Medical</td>
			<td>IN4130</td>
			<td>BasixCOMPAK with Analog Display</td>
		</tr>
		<tr>
			<td>Isoflurane</td>
			<td>MFR VETONE</td>
			<td>SKU-501017</td>
			<td>100mL, Liquid for Inhalation</td>
		</tr>
		<tr>
			<td>Microsurgery kit containing tweezers and forceps</td>
			<td>Customized</td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>Oxygen, E-tank</td>
			<td>Medline</td>
			<td>MDM1630</td>
			<td></td>
		</tr>
		<tr>
			<td>Sharpened Guidewire</td>
			<td>Customized</td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>Sterile Glad Press-n-Seal</td>
			<td>Glad</td>
			<td>SKU # PSS-140</td>
			<td>ETO Exposed</td>
		</tr>
		<tr>
			<td>Sterile Nonwoven Gauze Sponges 2s 4ply 4x4&#160;</td>
			<td>Medline</td>
			<td>SKU PRM21444H</td>
			<td>100Ct</td>
		</tr>
		<tr>
			<td>Surgical microscope&#160;</td>
			<td>Zeiss</td>
			<td>S100 / OPMI pico</td>
			<td></td>
		</tr>
		<tr>
			<td>Surgical Scrub &#38; Handwash</td>
			<td>Vetoquinol</td>
			<td>NDC: 17030-003-16</td>
			<td>16 oz</td>
		</tr>
		<tr>
			<td>Ultrasound Gel</td>
			<td>Medline</td>
			<td>CTR001305</td>
			<td>8.5 oz, 12/CS</td>
		</tr>
		<tr>
			<td>Ultrasound system</td>
			<td>Siemens</td>
			<td>ACUSON Antares</td>
			<td>3-D, Color, Continuous wave (CW), Pulsed wave (PW), Power CW/CW Spectral</td>
		</tr>
		<tr>
			<td>Venoplasty Balloon</td>
			<td>Customized</td>
			<td></td>
			<td></td>
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rodent inferior vena cava venoplasty balloon model

La veinoplastie par ballonnet est une technique clinique couramment utilisée pour traiter la sténose veineuse profonde et l’occlusion à la suite d’un traumatisme, d’anomalies anatomiques congénitales, de thrombose veineuse profonde aiguë (TVP) ou de la pose d’un stent. L’obstruction veineuse profonde chronique est caractérisée histopathologiquement par une thrombose, une fibrose ou les deux. À l’heure actuelle, aucun traitement direct n’est disponible pour cibler ces processus pathologiques. Par conséquent, un modèle animal in vivo fiable pour tester de nouvelles interventions est nécessaire. Le modèle de veinoplastie par ballonnet (VBM) de survie des rongeurs permet l’étude de la veinoplastie par ballonnet dans des conditions non thrombotiques et post-thrombotiques à plusieurs points temporels. L’effet local et systémique des ballonnets de veinoplastie avec et sans revêtement peut être quantifié à l’aide d’analyses tissulaires, de thrombus et sanguines telles que la réaction en chaîne par polymérase en temps réel (RT-PCR), le transfert Western, le test immuno-enzymatique (ELISA), la zymographie, l’analyse cellulaire de la paroi veineuse et du thrombus, les analyses de sang total et de plasma et l’analyse histologique. Le VBM est reproductible, reproduit les interventions chirurgicales humaines, peut identifier les modifications locales de la protéine thrombi de la paroi veineuse et permet plusieurs analyses à partir du même échantillon, réduisant ainsi le nombre d’animaux requis par groupe.

Deep vein obstructions from unresolved thrombi are a common consequence of deep vein thrombosis (DVT) and are one of the causes of post-thrombotic syndrome (PTS), costing billions of dollars in healthcare and significantly impacting the quality of life1,2,3. PTS is a unique inflammatory pathology with consequent vein wall fibrosis4 not fully captured in small animal DVT models5,6,7, and more importantly, previous models cannot evaluate the response to therapeutic interventions. Thrombotic venous obstructions are often treated by stenting and balloon venoplasty8,9; such interventions are hampered by a high reintervention rate due to restenosis and occlusion10,11,12.
Despite the availability of drug-coated balloons to address arterial-specific stenosis/occlusions, none exist for deep veins. The molecular mechanism behind restenosis is poorly understood in veins and has no direct therapy4. Therefore, our goal is to present an animal model that can test locally delivered therapeutics via venoplasty balloons simulating deep vein post-thrombotic obstructions. This model reproduces the post-thrombotic condition and evaluates how different types of venoplasty balloons affect the vein wall in vivo.

Pleins feux sur l’auteur : Utilisation d’un modèle de ballonnet de venénoplastie chez les rongeurs pour simuler des interventions chirurgicales pour les veines profondes

Rongeur inférieur Venoplastie Cave Venoplastie Modèle de ballon

In our laboratory, led by Dr.Andrea Obi, we study a type of abnormal blood clotting, venous thrombosis. In fact, we're one of the very few laboratories in the world working in this promising discovery area. Our goal is to take our findings and translate them into new, safer, more effective approaches to treat venous thrombosis.Our work has led us to look more closely at the role of the immune system, including the presence of infection in thrombus formation, as well as the pathways leading to clot resolution, venous fibrosis, including vein wall scarring and post-thrombotic syndrome. No previous animal model has been able to replicate the complex immune interactions that occur in venous thromboembolism in humans. Additionally, no model has been able to characterize the response to endovascular treatments followed by ultrasound.We are making important contributions to understand how different types of immune cells interact with environment around a blood clot, and how those interactions can lead to changes in the expression of cell's genetics code, a process now as epigenetic regulation. We believe that Inferior Vena Cava Venoplasty Balloon Model will accelerate the development of novel balloon angioplasty prototypes for the treatment of venous thrombosis, and the possibility for prevention of post-thrombotic syndrome.

Le VBM est un modèle qui évalue l’effet des ballonnets de veinoplastie dans le contrôle complet de l’hémostase. Tout d’abord, nous avons quantifié le diamètre IVC (section infrarénale moyenne), comme le montre la figure 1, pour une taille correcte du ballonnet. Deuxièmement, la technique microchirurgicale étape par étape développée est illustrée à la figure 2, et nous montrons également des exemples des étapes critiques à la <strong class=...

Le protocole présente un modèle de survie chez les rongeurs pour tester les interventions de veinoplastie par ballonnet (VB) dans les veines profondes non thrombotiques, thrombotiques et post-thrombotiques.

Balloon venoplasty is a commonly used clinical technique to treat deep vein stenosis and occlusion as a consequence of trauma, congenital anatomic ...

rodent-inferior-vena-cava-venoplasty-balloon-model

Research

JoVE Journal

Medicine

Rodent Inferior Vena Cava Venoplasty Balloon Model

Balloon venoplasty is a commonly used clinical technique to treat deep vein stenosis and occlusion as a consequence of trauma, congenital anatomic abnormalities, acute deep vein thrombosis (DVT), or stenting. Chronic deep venous obstruction is histopathologically characterized by thrombosis, fibrosis, or both. Currently, no direct treatment is available to target these pathological processes. Therefore, a reliable in vivo animal model to test novel interventions is necessary. The rodent survival inferior vena cava (IVC) venoplasty balloon model (VBM) allows the study of balloon venoplasty in non-thrombotic and post-thrombotic conditions across multiple time points. The local and systemic effect of coated and uncoated venoplasty balloons can be quantified via tissue, thrombus, and blood assays such as real-time polymerase chain reaction (RT-PCR), western blot, enzyme-linked immunosorbent assay (ELISA), zymography, vein wall and thrombus cellular analysis, whole blood and plasma assays, and histological analysis. The VBM is reproducible, replicates surgical human interventions, can identify local vein wall-thrombi protein changes, and allows multiple analyses from the same sample, decreasing the number of animals required per group.

The protocol presents a survival rodent model to test venoplasty balloon (VB) interventions in non-thrombotic, thrombotic, and post-thrombotic deep veins.

Recherche

Médecine

Developing a Rodent Venoplasty Balloon Model for Researching Deep Vein Stenosis Treatments

To begin, position the anesthetized rat for the ultrasound scanning of the inferior vena cava or IVC. Apply a conducting gel to the abdomen and orient the transducer in a transverse position. Using two-dimensional imaging mode or B mode, lower the 10 megahertz linear probe on the center of the abdomen.When the abdominal vessels come into view, differentiate the IVC from the abdominal aorta with compressibility and flow assessment. Once the IVC is located, identify the midsection in the middle third portion inferior to the renal veins and superior to the IVC bifurcation. At the midsection IVC, measure the wall to wall diameter in the transverse view using the cross-sectional B mode image, recording the widest diameter of the vessel.Store the data using compact disks as DICOM files. Clean the abdomen with gauze-soaked chlorhexidine scrub and chlorhexidine solution three times. Place the sterilized cling film as a surgical wrap to cover the rat thorax and abdominal area.Using iris scissors, make a three centimeter ventral midline incision approximately two centimeters below the xiphoid process through the skin and abdominal wall. With a sterile saline-soaked gauze, reflect the intestines to the animal's right side. Place a wire speculum in the incision to allow IVC visualization.Then using a sterile cotton tipped applicator, perform a blunt dissection. Employing a low temperature fine tip cautery, cauterize all IVC lumbar branches from the renal veins to the iliac bifurcation, and ligate side branches with 7-0 non-absorbable polypropylene sutures. Place a proximal curved vascular micro clip on the IVC, which is separated from the aorta and is inferior to the renal veins.Place a straight micro clip on the distal IVC superior to the iliac bifurcation. Place an 8-0 nylon U-stitch suture caudal to the left renal vein centered on the anterior surface of the IVC. Insert a 0.014 millimeter sharpened guide wire with the venoplasty balloon backloaded retrograde to blood flow into the infrarenal IVC caudal to the curved micro clip.Advance the balloon into the mid IVC using the Seldinger technique. Remove the sharpened guidewire and using a 20 milliliter inflation syringe, inflate the venoplasty balloon for three minutes with a 10 to 15%IVC overstretch. Flush sterile saline to all the systems before IVC cannulation to avoid air embolism.Tighten the U-stitch upon venoplasty balloon deflation and removal. Then remove the micro clips and close the laparotomy site in a two-layer fashion using a 3-0 polyglactin absorbable synthetic suture. Close both the abdominal wall and skin in a continuous pattern.Recover the rat in an individual cage and observe it for 30 minutes under a heating lamp placed 24 inches away from the cage before returning it to its original housing unit. Average pulsed wave doppler flow velocity in the inferior vena cava of the rats after clip placement of the vessel was significantly reduced.