在的鼠标Aortocaval瘘的技术方面
Summary
我们的目标是产生一个动静脉瘘，操作简便，重现。此方法不使用缝线或胶水粘合。因此，样品可以用最少的异物的量进行分析。
Abstract
技术方面创建鼠标的动静脉瘘的讨论。在全身麻醉，腹部切口，暴露主动脉和下腔静脉（IVC）。腹主动脉近端和远端主动脉解剖钳安置和针的穿刺，分别。特别注意的是，以避免夹层主动脉和下腔静脉之间。夹紧主动脉后，25 G针用于穿刺的主动脉两壁的进入下腔静脉。周围的结缔组织用于止血压缩的。成功创建AVF将显示下腔静脉搏动的动脉血流。成功AVF可以通过多普勒超声手术后进一步确认。
Introduction
终末期肾病患者肾脏替代治疗在选择最常用的选项是血液透析。访问进行血液透析动静脉瘘（AVF），动静脉移植物，或临时导管置入。 AVF虽然是首选的访问模式，AVF还不够完善。一年主要AVF通畅率只有60-65％，许多次的失败，由于内膜增生。正常AVF的形成和适应不良形成的分子生物学和生理学仍然很差的特点。因此，很多得到改善AVF结果与随附增益理解瘘形成的调控。1-3
曝光静脉动脉血流通常研究的背景下静脉移植旁路手术是直接模式，4，5，虽然静脉移植和AVF同样暴露静脉动脉的环境，有几个关键的二它们之间fferences。首先，前端径流床的电阻是低得多的动静脉瘘，，AVF下水道右心房，而静脉移植水渠往往病变远侧小动脉，导致血流增加和剪切应力，在动静脉瘘。第二，血液中的动静脉瘘的静脉肢体可导致比纯粹的动脉静脉移植物中的含量较低的氧合静脉和动脉血液的混合物中。三，静脉AVF不会删除从它的床上，导致其venorum血管和神经支配保存，移植静脉完全性动脉床。最后，在静脉移植物吻合的数量通常是两个，而AVF通常只有一个。在这项研究中，我们将介绍的小鼠模型中aortocaval瘘，可用于AVF研究。
Protocol
Representative Results
Discussion
有几个报告所描述的动静脉瘘管的影响，包括股骨AVF，6，7颈颈AVF 8和主动脉腔AVF。9，10，将大鼠比鼠标大几倍，允许更容易的手术相比，在大鼠鼠标。然而，为了利用小鼠遗传品系和变体的步骤，必须扩大到包括小鼠模型。几个先前公布的报告介绍了AVF的小鼠模型中，但这些报告一般都在开发一个模型右路心脏衰竭的背景下，使用较大尺寸的针头。11-13古斯曼我?…
Divulgazioni
The authors have nothing to disclose.
Acknowledgements
这项工作是由国家卫生部授予R01-HL095498在弗吉尼亚州，西黑文，CT康涅狄格卫生保健系统的资源和设施的使用，以及部分支持。
Materials
| Name of equipment | Company | Catalog number | Comments (optional) |
| Vevo 770 ultrasound machine | Visualsonics | 20-60 Mhz scan head; RMV-704 | |
| Vascular clamp | Roboz Surgical Instrument Co. | RS-5424 | |
| Clamp applying forceps | Roboz Surgical Instrument Co. | RS-5410 | |
| 25 Gauge Needle | Becton Dickinson | BD PrecisionGlide Needle 25 G x 7/8 #305124 |
Riferimenti
- Allon, M. Current management of vascular access. Clinical Journal of the American Society of Nephrology. 2 (4), 786-800 (2007).
- Dixon, B. S. Why don’t fistulas mature?. Kidney International. 70 (8), 1413-1422 (2006).
- Roy-Chaudhury, P., Spergel, L. M., Besarab, A., Asif, A., Ravani, P. Biology of arteriovenous fistula failure. Journal of Nephrology. 20 (2), 150-163 (2007).
- Kudo, F. A., Muto, A., et al. Venous identity is lost but arterial identity is not gained during vein graft adaptation. Arteriosclerosis, Thrombosis, and Vascular Biology. 27 (7), 1562-1571 (2007).
- Muto, A., Yi, T., et al. Eph-B4 prevents venous adaptive remodeling in the adult arterial environment. The Journal of Experimental Medicine. 208 (3), 561-575 (2011).
- Croatt, A. J., Grande, J. P., et al. Characterization of a model of an arteriovenous fistula in the rat: the effect of L-NAME. The American Journal of Pathology. 176 (5), 2530-2541 (2010).
- Misra, S., Fu, A. A., et al. The rat femoral arteriovenous fistula model: increased expression of matrix metalloproteinase-2 and -9 at the venous stenosis. Journal of Vascular and Interventional Radiology. 19 (4), 587-594 (2008).
- Kojima, T., Miyachi, S., et al. The relationship between venous hypertension and expression of vascular endothelial growth factor: hemodynamic and immunohistochemical examinations in a rat venous hypertension model. Surgical Neurology. 68 (3), 277-284 (2007).
- Caplice, N. M., Wang, S., et al. Neoangiogenesis and the presence of progenitor cells in the venous limb of an arteriovenous fistula in the rat. American Journal of Physiology Renal Physiology. 293 (2), F470-F475 (2007).
- Nath, K. A., Kanakiriya, S. K., Grande, J. P., Croatt, A. J., Katusic, Z. S. Increased venous proinflammatory gene expression and intimal hyperplasia in an aorto-caval fistula model in the rat. The American Journal of Pathology. 162 (6), 2079-2090 (2003).
- Karram, T., Hoffman, A., et al. Induction of cardiac hypertrophy by a controlled reproducible sutureless aortocaval shunt in the mouse. Journal of Investigative Surgery. 18 (6), 325-334 (2005).
- Perry, G. J., Mori, T., et al. Genetic variation in angiotensin-converting enzyme does not prevent development of cardiac hypertrophy or upregulation of angiotensin II in response to aortocaval fistula. Circulation. 103 (7), 1012-1016 (2001).
- Guzman, R. J., Krystkowiak, A., Zarins, C. K. Early and sustained medial cell activation after aortocaval fistula creation in mice. The Journal of Surgical Research. 108 (1), 112-121 (2002).
- Castier, Y., Lehoux, S., et al. Characterization of neointima lesions associated with arteriovenous fistulas in a mouse model. Kidney International. 70 (2), 315-320 (2006).
