Park Ik-Seong, Meno Joseph R, Witt Cordelie E, Suttle Timothy K, Chowdhary Abhineet, Nguyen Thien-Son, Ngai Al C, Britz Gavin W
Department of Neurological Surgery, University of Washington, Harborview Medical Center, Box 359914, Seattle, WA 98104, United States.
J Neurosci Methods. 2008 Jul 30;172(2):195-200. doi: 10.1016/j.jneumeth.2008.04.027. Epub 2008 May 4.
The present study describes modifications to the endovascular filament model of subarachnoid hemorrhage (SAH) in rats. Specifically, we sought to improve the percentage yield of SAH, reduce mortality rates and better simulate human cerebral aneurysmal rupture. Instead of using a 4-0 prolene suture to induce SAH in the existing endovascular filament model, a hollow and flexible polyetrafluoroethylene (PTFE) tube was maneuvered into the proximal anterior cerebral artery (ACA) to ensure that advancement occurred without producing trauma to the vessels. SAH was induced by advancing a tungsten wire through this tube, perforating the ACA at the desired location. These modifications produced significant improvements over the endovascular filament model. Mortality rate declined from 46 to 19%, and SAH was produced more frequently. With the prolene suture, only 48% of our attempts produced a SAH, and unsuccessful attempts typically resulted in an acute subdural hematoma (ASDH). In contrast, the wire/tubing technique was 90% successful at inducing SAH, and led to a significant reduction of ASDH incidence from 44 to 6%. Additionally, the modified technique produced vasospasm in basilar and middle cerebral arteries post-SAH as well as pseudoaneurysms in the proximal ACA which indicated the location of vessel perforation.
本研究描述了对大鼠蛛网膜下腔出血(SAH)血管内丝线模型的改进。具体而言,我们试图提高SAH的成功率,降低死亡率,并更好地模拟人类脑动脉瘤破裂。在现有的血管内丝线模型中,不再使用4-0普理灵缝线诱导SAH,而是将一根中空且柔韧的聚四氟乙烯(PTFE)管插入大脑前动脉近端(ACA),以确保推进过程中不会对血管造成损伤。通过将钨丝穿过该管,在所需位置穿破ACA来诱导SAH。这些改进相对于血管内丝线模型有显著提升。死亡率从46%降至19%,SAH的诱导更为频繁。使用普理灵缝线时,我们的尝试中只有48%成功诱导出SAH,未成功的尝试通常导致急性硬膜下血肿(ASDH)。相比之下,钨丝/导管技术诱导SAH的成功率为90%,并使ASDH的发生率从44%显著降至6%。此外,改良技术在SAH后导致基底动脉和大脑中动脉发生血管痉挛,以及在ACA近端形成假性动脉瘤,这表明了血管穿孔的位置。