Ehlert Angelika, Budde Ulrich, Middendorff Ralf, Manthei Gerd, Kemmling Andre, Tiemann Bastian
Department of Neurosurgery, Asklepios Klinik St. Georg Hamburg, Hamburg, Germany.
Department of Haemostasiologie, Asklepios Klinik Altona, Hamburg, Germany.
J Neurol Surg A Cent Eur Neurosurg. 2018 Sep;79(5):424-433. doi: 10.1055/s-0038-1641561. Epub 2018 Jul 4.
Cerebral vasospasm as a delayed, possibly treatable sequel of subarachnoid hemorrhage (SAH) is a focus of experimental animal research. For this purpose, the rat is not a good model because of the difficulty creating a stable subarachnoid clot that persists > 1 to 2 days and could induce vasospasm. Only in rat models with a high mortality of ∼ 50% or more can SAH and its effects be investigated. Therefore, other animals than rodents are used for investigating the delayed effects of SAH. Only animal studies addressing the acute effects of SAH use rats.
We designed a model that allows intensive clot formation combined with low mortality to facilitate studies on the delayed effects of experimental SAH, for example, delayed vasospasm or other alterations of vessels.
After in vitro acceleration of the clotting process in the rats' blood by tissue factor and preliminary in vivo testing, we induced a SAH by injecting blood together with tissue factor in 22 rats. We analyzed clot expansion, length of clot persistence, chronic alterations, and histologic changes.
The injection of blood supplemented by tissue factor led to persistent voluminous blood clots in the subarachnoid space close to the large arteries. Despite the pronounced SAH, all animals survived, allowing investigation of delayed SAH effects. All animals killed within the first 7 days after surgery had extensive clots; in some animals, the clots remained until postoperative day 12. During further clot degradation connective tissue appeared, possibly as a precursor of SAH-related late hydrocephalus.
The injection of blood together with tissue factor significantly improves SAH induction in the rat model. This rat model allows studying delayed SAH effects as found in humans.
作为蛛网膜下腔出血(SAH)的一种延迟性、可能可治疗的后遗症,脑血管痉挛是实验动物研究的一个重点。出于这个目的,大鼠不是一个好的模型,因为难以形成持续超过1至2天并能诱发血管痉挛的稳定蛛网膜下腔血凝块。只有在死亡率约为50%或更高的大鼠模型中才能研究SAH及其影响。因此,除啮齿动物外的其他动物被用于研究SAH的延迟影响。只有研究SAH急性影响的动物研究使用大鼠。
我们设计了一种模型,该模型允许密集的血凝块形成并结合低死亡率,以促进对实验性SAH延迟影响的研究,例如延迟性血管痉挛或血管的其他改变。
在通过组织因子体外加速大鼠血液凝固过程并进行初步体内测试后,我们在22只大鼠中通过注射血液和组织因子诱导SAH。我们分析了血凝块扩张、血凝块持续时间、慢性改变和组织学变化。
注射补充了组织因子的血液导致在靠近大动脉的蛛网膜下腔形成持续的大量血凝块。尽管有明显的SAH,但所有动物均存活,从而能够研究SAH的延迟影响。在手术后的前7天内处死的所有动物都有广泛的血凝块;在一些动物中,血凝块一直存在到术后第12天。在血凝块进一步降解过程中出现了结缔组织,可能是SAH相关晚期脑积水的前兆。
注射血液和组织因子可显著改善大鼠模型中SAH的诱导。这种大鼠模型允许研究在人类中发现的SAH延迟影响。