Nevzati Edin, Rey Jeannine, Coluccia Daniel, D'Alonzo Donato, Grüter Basil, Remonda Luca, Fandino Javier, Marbacher Serge
Department of Neurosurgery, Kantonsspital Aarau; Neuro Lab, Research Group for Experimental Neurosurgery and Neurocritical Care, Department of Intensive Care Medicine, University Hospital and University of Bern;
Neuro Lab, Research Group for Experimental Neurosurgery and Neurocritical Care, Department of Intensive Care Medicine, University Hospital and University of Bern.
J Vis Exp. 2017 Oct 1(128):56359. doi: 10.3791/56359.
The steady progess in the armamentarium of techniques available for endovascular treatment of intracranial aneurysms requires affordable and reproducable experimental animal models to test novel embolization materials such as stents and flow diverters. The aim of the present project was to design a safe, fast, and standardized surgical technique for stent assisted embolization of saccular aneurysms in a rat animal model. Saccular aneurysms were created from an arterial graft from the descending aorta.The aneurysms were microsurgically transplanted through end-to-side anastomosis to the infrarenal abdominal aorta of a syngenic male Wistar rat weighing >500 g. Following aneurysm anastomosis, aneurysm embolization was performed using balloon expandable magnesium stents (2.5 mm x 6 mm). The stent system was retrograde introduced from the lower abdominal aorta using a modified Seldinger technique. Following a pilot series of 6 animals, a total of 67 rats were operated according to established standard operating procedures. Mean surgery time, mean anastomosis time, and mean suturing time of the artery puncture site were 167 ± 22 min, 26 ± 6 min and 11 ± 5 min, respectively. The mortality rate was 6% (n=4). The morbidity rate was 7.5% (n=5), and in-stent thrombosis was found in 4 cases (n=2 early, n=2 late in stent thrombosis). The results demonstrate the feasibility of standardized stent occlusion of saccular sidewall aneurysms in rats - with low rates of morbidity and mortality. This stent embolization procedure combines the opportunity to study novel concepts of stent or flow diverter based devices as well as the molecular aspects of healing.
颅内动脉瘤血管内治疗可用技术手段的不断进步，需要价格合理且可重复的实验动物模型来测试新型栓塞材料，如支架和血流分流器。本项目的目的是在大鼠动物模型中设计一种安全、快速且标准化的手术技术，用于囊状动脉瘤的支架辅助栓塞。囊状动脉瘤由降主动脉的动脉移植物制成。通过端侧吻合将动脉瘤显微手术移植到体重>500 g的同基因雄性Wistar大鼠的肾下腹主动脉。动脉瘤吻合后，使用球囊可扩张镁支架（2.5 mm×6 mm）进行动脉瘤栓塞。采用改良的Seldinger技术从下腹主动脉逆行引入支架系统。在对6只动物进行预试验系列后，根据既定的标准操作程序，共对67只大鼠进行了手术。平均手术时间、平均吻合时间和动脉穿刺部位的平均缝合时间分别为167±22分钟、26±6分钟和11±5分钟。死亡率为6%（n = 4）。发病率为7.5%（n = 5），4例（n = 2早期，n = 2晚期支架内血栓形成）发现支架内血栓形成。结果表明，大鼠囊状侧壁动脉瘤标准化支架闭塞具有可行性，发病率和死亡率较低。这种支架栓塞程序为研究基于支架或血流分流器的装置的新概念以及愈合的分子方面提供了机会。
