Isaji Toshihiko, Ono Shun, Hashimoto Takuya, Yamamoto Kota, Taniguchi Ryosuke, Hu Haidi, Wang Tun, Koizumi Jun, Nishibe Toshiya, Hoshina Katsuyuki, Dardik Alan
Department of Surgery, Yale University; Vascular Biology and Therapeutics Program, Yale University; Department of Vascular Surgery, University of Tokyo.
Department of Surgery, Yale University; Vascular Biology and Therapeutics Program, Yale University; Department of Diagnostic Radiology, Tokai University School of Medicine; Department of Cardiovascular Surgery, Tokyo Medical University.
J Vis Exp. 2019 Jul 11(149). doi: 10.3791/59540.
Central venous stenosis is an important entity contributing to arteriovenous fistula (AVF) failure. A murine AVF model was modified to create a partial ligation of the inferior vena cava (IVC) in the outflow of the fistula, mimicking central venous stenosis. Technical aspects of this model are introduced. The aorta and IVC are exposed, following an abdominal incision. The infra-renal aorta and IVC are dissected for proximal clamping, and the distal aorta is exposed for puncture. The IVC at the midpoint between the left renal vein and the aortic bifurcation is carefully dissected to place an 8-0 suture beneath the IVC. After clamping the aorta and IVC, an AVF is created by puncturing the infra-renal aorta through both walls into the IVC with a 25 G needle, followed by ligating a 22 G intra-venous (IV) catheter and IVC together. The catheter is then removed, creating a reproducible venous stenosis without occlusion. The aorta and IVC are unclamped after confirming primary hemostasis. This novel model of central vein stenosis is easy to perform, reproducible, and will facilitate studies on AVF failure.
中心静脉狭窄是导致动静脉内瘘（AVF）失败的一个重要因素。对小鼠AVF模型进行了改良，在瘘管流出道处对下腔静脉（IVC）进行部分结扎，模拟中心静脉狭窄。介绍了该模型的技术要点。经腹部切口暴露主动脉和IVC。解剖肾下主动脉和IVC以进行近端钳夹，并暴露远端主动脉以便穿刺。仔细解剖左肾静脉与主动脉分叉之间中点处的IVC，在IVC下方放置一根8-0缝线。钳夹主动脉和IVC后，用25G针头经两壁穿刺肾下主动脉进入IVC，建立AVF，然后将一根22G静脉（IV）导管与IVC结扎在一起。随后拔出导管，形成可重复的静脉狭窄但不闭塞。确认初步止血后松开主动脉和IVC。这种新型的中心静脉狭窄模型操作简便、可重复，将有助于开展关于AVF失败的研究。
