显微静脉袋分岔动脉瘤在兔模型：技术问题
1Department of Neurosurgery,Hospital Rudolfstiftung, 2Department of Neurosurgery,Kantonsspital Aarau, 3Cerebrovascular Research Group, Department of Biomedical Research,Medical University of Vienna, 4Cerebrovascular Research Group, Department of Intensive Care Medicine,University of Berne, 5Centre for Anatomy and Cell Biology, Department of Systematic Anatomy,Medical University of Vienna, 6Department of Neurology,Paracelsus University Salzburg
Summary
优化技术是模仿分叉人类的脑血管瘤的动脉分叉处动脉瘤的显微创造的一个描述。静脉袋是缝合成一个人为创造的真正的双侧颈总动脉分叉处。促成的显微外科技术和积极的术后抗凝，镇痛导致最小化的发病率和高瘤通畅率。
Abstract
人类破裂脑动脉瘤血管内栓塞治疗已成为等效替代动脉瘤夹闭1。然而，大规模的临床试验表明令人失望的长期结果，与动脉瘤的血管再通和延迟动脉瘤破裂不可接受的高利率（2）为了克服这些问题，动物实验研究为更好的血管内设备的发展是至关重要的 。3-5
几种动物模型，大鼠，兔，犬和猪 6-8不同的动物模型的比较表明家兔模型的血流动力学及凝血系统的可比性和成本效益方面的优越性。9-11
静脉袋家兔动脉分叉模型是由双方共同的颈总动脉（CCA）的真正成为一个人为制造的分叉缝合静脉袋。这种模式的主要优点是真正的bifurcational血流动力学，12的主要缺点是SOFAR高的显微外科技术的需求和高发病率和死亡率高达50％。13这些限制导致在最近的这个动脉瘤模型的频繁使用年。这些缺点是可以克服的改善外科手术和修改城郊14-16我们的技术和术后止痛管理和抗凝。本文报道证明这一点动脉分叉处动脉瘤的显微创造优化技术。
Protocol
1。定位和配制的动物实验是由负责当地的伦理委员会批准，并根据Felasa指引。 启动女性新西兰白兔（2.5-3.5公斤），氯胺酮肌肉注射（30mg/kg）和甲苯噻嗪（6mg/kg）全身麻醉后继续气体麻醉插管机械（管直径4mm，长18mm）（在心电监护下的异氟醚）。执行监测通过脚趾捏15分钟的痛苦，并在积极回应的情况下适应麻醉。 修复兔仰卧位上bodywarm板。 准备手术?…
Discussion
作者建议体贴以下关键手术的关键步骤，以取得良好的成果和专利瘤：
- 仔细解剖一个不容易破坏神经和小血管吻合的长段的左CCA。
- 创造吻合前仔细去除高凝血periadventitial纤维组织。
- 创建一个张力吻合。
- 更少的缝线：建议anastomsis网站开始在背面的序列提供了更好的的控制比以前建议的程序，这些最困难的缝线12,13,18。
- 密封使用脂肪垫或更好的纤维蛋白…
Disclosures
The authors have nothing to disclose.
Acknowledgements
这项研究是支持和爱惜康生物外科，新泽西州，美国“医学维也纳市的主要科学基金”。作者表达自己的感谢了宝贵的显微教学主任，“欧洲研讨会上的显微外科和脑心肌血运重建术”，奥地利维也纳医科大学教授希伯的Ferraz雷特。
Materials
| Name of the reagent | Company | Catalogue number | Comments |
|---|---|---|---|
| Vicryl4-0 polyfilament restorable sutures | Ethicon Inc | J386H | |
| Ethilon 10-0 monofil non resorbable sutures | Ethicon Inc | 2814 | taper point needle |
| Evicel Bioglue | Ethicon Biosurgery Inc. | 3901 | |
| Fentanyl dermal patch 12.5 μg/h | Any genericon | ||
| Heparin | Any genericon | ||
| 0.9% Saline | Any genericon | ||
| 4% Papaverin HCl | Any genericon | ||
| Neomycin sulfate 5 mg/ml | Any genericon | ||
| Ketamin 50mg/ml | Any genericon | ||
| Xylazine 20mg/ml | Any genericon |
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Tags
MicrosurgicalVenous PouchArterial-bifurcation AneurysmsRabbit ModelTechnical AspectsEndovascular EmbolizationAneurysm ClippingClinical TrialsAneurysm RecanalizationDelayed Aneurysm RuptureAnimal Experimental StudiesEndovascular DevicesAnimal ModelsRatsRabbitsCaninesSwineHemodynamicsCoagulation SystemCost-effectivenessVenous Pouch Arterial Bifurcation ModelCommon Carotid Arteries (CCA)Microsurgical Technical DemandsMorbidity And Mortality RatesSurgical ProceduresPerioperative Analgesic ManagementAnticoagulation
Cite This Article
Sherif, C., Fandino, J., Erhardt, S., di Ieva, A., Killer, M., Kleinpeter, G., Marbacher, S. Microsurgical Venous Pouch Arterial-Bifurcation Aneurysms in the Rabbit Model: Technical Aspects. J. Vis. Exp. (51), e2718, doi:10.3791/2718 (2011).