Complex Bilobular, Bisaccular, and Broad-Neck Microsurgical Aneurysm Formation in the Rabbit Bifurcation Model for the Study of Upcoming Endovascular Techniques

Marbacher, Serge; Erhardt, Salome; Schläppi, Janine-Ai; Coluccia, Daniel; Remonda, Luca; Fandiño, Javier; Sherif, Camillo

doi:10.3174/ajnr.a2374

Cited by 22 publications

(21 citation statements)

References 11 publications

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“…An average total operation time of less than 60 minutes for microsurgical creation of a sidewall aneurysm in rats is much shorter than the time used for creation of more complex microsurgical venous pouch arterial bifurcation aneurysm in rabbits and dogs 2,14,15 . The advantages of low costs and faster methods of aneurysm creation may facilitate conduction of studies with larger number of experiments and subsequent increased statistical power.…”

Section: Discussionmentioning

confidence: 99%

“…For these purposes, several different models in different species have been developed and published 1 . Larger aneurysm models in pigs, dogs, and rabbits are preferably used to test endovascular innovations in complex aneurysm architecture 1,2 . Murine aneurysm models, on the other hand, allow testing research questions in genetically modified species 3,4 and facilitate clarification of aneurysm biology at cellular and molecular level far better than larger species 1 .…”

Section: Introductionmentioning

confidence: 99%

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The Helsinki Rat Microsurgical Sidewall Aneurysm Model

Marbacher

Marjamaa

Abdelhameed

et al. 2014

JoVE

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Experimental saccular aneurysm models are necessary for testing novel surgical and endovascular treatment options and devices before they are introduced into clinical practice. Furthermore, experimental models are needed to elucidate the complex aneurysm biology leading to rupture of saccular aneurysms.Several different kinds of experimental models for saccular aneurysms have been established in different species. Many of them, however, require special skills, expensive equipment, or special environments, which limits their widespread use. A simple, robust, and inexpensive experimental model is needed as a standardized tool that can be used in a standardized manner in various institutions.The microsurgical rat abdominal aortic sidewall aneurysm model combines the possibility to study both novel endovascular treatment strategies and the molecular basis of aneurysm biology in a standardized and inexpensive manner. Standardized grafts by means of shape, size, and geometry are harvested from a donor rat's descending thoracic aorta and then transplanted to a syngenic recipient rat. The aneurysms are sutured end-to-side with continuous or interrupted 9-0 nylon sutures to the infrarenal abdominal aorta.We present step-by-step procedural instructions, information on necessary equipment, and discuss important anatomical and surgical details for successful microsurgical creation of an abdominal aortic sidewall aneurysm in the rat. Video LinkThe video component of this article can be found at

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The Helsinki Rat Microsurgical Sidewall Aneurysm Model

Marbacher

Marjamaa

Abdelhameed

et al. 2014

JoVE

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“…To simulate arterial bifurcation aneurysms, a technique was developed to create venous pouch aneurysms using a jugular venous graft at a surgically induced bifurcation at the end-to-side anastomosis of the left CCA to the right CCA. 20 Marbacher et al 42 modified this technique to create a more complicated aneurysm by grafting large, wide-necked, bilobar, and bisaccular venous pouches to this surgically created bifurcation. Most recently, a very broad-necked aneurysm model was developed by longitudinally opening a segment of the jugular vein and grafting this patch to the CCA.…”

Section: Venous Graft Aneurysmmentioning

confidence: 99%

In vivo cerebral aneurysm models

Thompson

Elwardany

McCarthy

et al. 2019

Neurosurgical Focus

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Cerebral aneurysm rupture is a devastating event resulting in subarachnoid hemorrhage and is associated with significant morbidity and death. Up to 50% of individuals do not survive aneurysm rupture, with the majority of survivors suffering some degree of neurological deficit. Therefore, prior to aneurysm rupture, a large number of diagnosed patients are treated either microsurgically via clipping or endovascularly to prevent aneurysm filling. With the advancement of endovascular surgical techniques and devices, endovascular treatment of cerebral aneurysms is becoming the first-line therapy at many hospitals. Despite this fact, a large number of endovascularly treated patients will have aneurysm recanalization and progression and will require retreatment. The lack of approved pharmacological interventions for cerebral aneurysms and the need for retreatment have led to a growing interest in understanding the molecular, cellular, and physiological determinants of cerebral aneurysm pathogenesis, maturation, and rupture. To this end, the use of animal cerebral aneurysm models has contributed significantly to our current understanding of cerebral aneurysm biology and to the development of and training in endovascular devices. This review summarizes the small and large animal models of cerebral aneurysm that are being used to explore the pathophysiology of cerebral aneurysms, as well as the development of novel endovascular devices for aneurysm treatment.

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“…However, the rabbit venous pouch model could be substantially improved. 4,5 It now offers equivalent patency and morbidity rates compared with the rabbit elastase and canine bifurcation models. Additionally, the unaltered vein transplant aneurysm walls of venous pouch bifurcation models show many similarities to the walls of human intracranial aneurysms.…”

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confidence: 96%

Quantitative Angiographic and Histopathologic Evaluation of Experimental Aneurysms

Sherif¹,

Plenk²

2010

AJNR Am J Neuroradiol

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The article of Bouzeghrane et al 1 is a timely and surely important contribution to reaching standardized quality criteria for experimental aneurysm models and evaluation techniques. Nevertheless, the following comments should be added.The authors of the above-mentioned article state that the lack of correlation between angiographic and histopathologic results is a major limitation to the validity of experimental aneurysm studies. This statement holds true if subjective estimation of aneurysm occlusion is used as in most of the cited literature. However, our studies have shown good correlation of angiographic and histopathologic occlusion rates by applying a new method of computerized quantification, first on 8 venous pouch bifurcation aneurysms in rabbits. 2 Because this correlation reached statistical significance in a subsequent large postmortem series of 14 human aneurysms, 3 the superior precision of computer-assisted quantification for evaluating angiograms and corresponding surface-stained ground sections from polymethylmethacrylate-embedded aneurysms has been validated.Concerning the best suitable specimen preparation for histopathologic evaluation, the authors stated that cutting-grinding techniques with the devices in situ preclude advanced histotechniques such as immunohistochemistry. This limitation applies only to the past because currently several resin-embedding techniques and materials (eg, Technovit 9100 New; Heraeus Kulzer, Wehrheim, Germany) are available, in which denaturation of proteins is avoided by low polymerization temperatures (at Ϫ20°C). Therefore, the major advantage of histotechniques preserving the implants in situ to evaluate cell reactions at implant-tissue interfaces can now be combined with immunocytohistochemistry.As a critique of the rabbit venous pouch bifurcation model, Bouzeghrane et al 1 showed, in Table 4, that neck endothelialization was not described and thrombus organization in the aneurysm sac was not properly followed because only uncovered coils were found in the lumen and no fibrosis was visible between the loops of coils. However, all these features of aneurysm healing have been described in detail by our group 2 and also by several other authors in rabbit venous pouch aneurysms. Bouzeghrane et al also concluded that the rabbit venous pouch bifurcation aneurysm model resulted so far in lower rates of aneurysm patency and higher rates of morbidity, making it less appropriate for embolic device evaluations as in, for example, the rabbit elastase model. However, the rabbit venous pouch model could be substantially improved. 4,5 It now offers equivalent patency and morbidity rates compared with the rabbit elastase and canine bifurcation models. Additionally, the unaltered vein transplant aneurysm walls of venous pouch bifurcation models show many similarities to the walls of human intracranial aneurysms. With proper technique, the foreign body reactions to the sutures are only located outside the aneurysms and, thus will not interfere with reactions to embolic devices...

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Complex Bilobular, Bisaccular, and Broad-Neck Microsurgical Aneurysm Formation in the Rabbit Bifurcation Model for the Study of Upcoming Endovascular Techniques

Cited by 22 publications

References 11 publications

The Helsinki Rat Microsurgical Sidewall Aneurysm Model

The Helsinki Rat Microsurgical Sidewall Aneurysm Model

In vivo cerebral aneurysm models

Quantitative Angiographic and Histopathologic Evaluation of Experimental Aneurysms

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