Marbacher Serge, Wanderer Stefan, Strange Fabio, Grüter Basil E, Fandino Javier
Department of Neurosurgery, Kantonsspital Aarau, Aarau 5000, Switzerland.
Cerebrovascular Research Group, Department for BioMedical Research, University of Bern, Bern 3000, Switzerland.
Brain Sci. 2020 Feb 13;10(2):101. doi: 10.3390/brainsci10020101.
Most available large animal extracranial aneurysm models feature healthy non-degenerated aneurysm pouches with stable long-term follow-ups and extensive healing reactions after endovascular treatment. This review focuses on a small subgroup of extracranial aneurysm models that demonstrated growth and potential rupture during follow-up.
The literature was searched in Medline/Pubmed to identify extracranial in vivo saccular aneurysm models featuring growth and rupture, using a predefined search strategy in accordance with the PRISMA guidelines. From eligible studies we extracted the following details: technique and location of aneurysm creation, aneurysm pouch characteristics, time for model creation, growth and rupture rate, time course, patency rate, histological findings, and associated morbidity and mortality.
A total of 20 articles were found to describe growth and/or rupture of an experimentally created extracranial saccular aneurysm during follow-up. Most frequent growth was reported in rats ( = 6), followed by rabbits ( = 4), dogs ( = 4), swine ( = 5), and sheep ( = 1). Except for two studies reporting growth and rupture within the abdominal cavity (abdominal aortic artery; = 2) all other aneurysms were located at the neck of the animal. The largest growth rate, with an up to 10-fold size increase, was found in a rat abdominal aortic sidewall aneurysm model.
Extracranial saccular aneurysm models with growth and rupture are rare. Degradation of the created aneurysmal outpouch seems to be a prerequisite to allow growth, which may ultimately lead to rupture. Since it has been shown that the aneurysm wall is important for healing after endovascular therapy, it is likely that models featuring growth and rupture will gain in interest for preclinical testing of novel endovascular therapies.
大多数现有的大型动物颅外动脉瘤模型具有健康、未退化的动脉瘤囊袋，长期随访稳定，血管内治疗后有广泛的愈合反应。本综述聚焦于一小部分颅外动脉瘤模型，这些模型在随访期间出现了生长和潜在破裂。
按照PRISMA指南，使用预定义的搜索策略在Medline/Pubmed中检索文献，以识别具有生长和破裂特征的颅外体内囊状动脉瘤模型。从符合条件的研究中，我们提取了以下详细信息：动脉瘤创建的技术和位置、动脉瘤囊袋特征、模型创建时间、生长和破裂率、时间进程、通畅率、组织学发现以及相关的发病率和死亡率。
共发现20篇文章描述了实验创建的颅外囊状动脉瘤在随访期间的生长和/或破裂情况。报告生长最频繁的是大鼠（=6），其次是兔子（=4）、狗（=4）、猪（=5）和绵羊（=1）。除两项报告腹腔内（腹主动脉；=2）生长和破裂的研究外，所有其他动脉瘤均位于动物颈部。在大鼠腹主动脉侧壁动脉瘤模型中发现了最大的生长率，大小增加了10倍。
具有生长和破裂的颅外囊状动脉瘤模型很少见。创建的动脉瘤外突的退化似乎是允许生长的先决条件，这最终可能导致破裂。由于已经表明动脉瘤壁对血管内治疗后的愈合很重要，具有生长和破裂特征的模型可能会在新型血管内治疗的临床前测试中受到更多关注。
