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Raviol J, Plet G, Langlois JB, Si-Mohamed S, Magoariec H, Pailler-Mattei C. In vivo mechanical characterization of arterial wall using an inverse analysis procedure: application on an animal model of intracranial aneurysm. ROYAL SOCIETY OPEN SCIENCE 2024; 11:231936. [PMID: 38633347 PMCID: PMC11022001 DOI: 10.1098/rsos.231936] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Revised: 02/19/2024] [Accepted: 02/24/2024] [Indexed: 04/19/2024]
Abstract
Intracranial aneurysm is a pathology related to the deterioration of the arterial wall. This work is an essential part of a large-scale project aimed at providing clinicians with a non-invasive patient-specific decision support tool to facilitate the rupture risk assessment. It will lean on the link between the aneurysm shape clinically observed and a database derived from the in vivo mechanical characterization of aneurysms. To supply this database, a deformation device prototype of the arterial wall was developed. Its use coupled with medical imaging (spectral photon-counting computed tomography providing a spatial resolution down to 250 μm) is used to determine the in vivo mechanical properties of the wall based on the inverse analysis of the quantification of the wall deformation observed experimentally. This study presents the in vivo application of this original procedure to an animal model of aneurysm. The mechanical properties of the aneurysm wall identified were consistent with the literature, and the errors between the numerical and experimental results were less than 10%. Based on these parameters, this study allows the assessment of the aneurysm stress state for a known solicitation and points towards the definition of a rupture criterion.
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Affiliation(s)
- J. Raviol
- Ecole Centrale de Lyon, CNRS, ENTPE, LTDS, UMR 5513, Écully69130, France
| | - G. Plet
- Ecole Centrale de Lyon, CNRS, ENTPE, LTDS, UMR 5513, Écully69130, France
| | | | - S. Si-Mohamed
- Université de Lyon, INSA Lyon, Université Claude Bernard Lyon 1, UJM-Saint Etienne, CNRS, Inserm, CREATIS UMR 5220, U1206, F69621, Villeurbanne69100, France
- Département de Radiologie, Hôpital Louis Pradel, Hospices Civils de Lyon, Bron69677, France
| | - H. Magoariec
- Ecole Centrale de Lyon, CNRS, ENTPE, LTDS, UMR 5513, Écully69130, France
| | - C. Pailler-Mattei
- Ecole Centrale de Lyon, CNRS, ENTPE, LTDS, UMR 5513, Écully69130, France
- Université de Lyon, Université Claude Bernard Lyon 1, ISPB-Faculté de Pharmacie, Lyon69008, France
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2
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Bisharat DR, Johnson J, Mühl-Benninghaus R, Tomori T, Lago J, Virmani R, Reith W, Simgen A. Evaluation of a novel polymer coil for endovascular occlusion of intracranial aneurysms in a rabbit model. Neuroradiol J 2024; 37:31-38. [PMID: 37586720 PMCID: PMC10863565 DOI: 10.1177/19714009231196474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/18/2023] Open
Abstract
BACKGROUND AND PURPOSE The results of the preclinical study of a novel polymer coil in treatment of elastase induced aneurysms will be presented in this paper. MATERIAL AND METHODS We induced 16 aneurysms in 16 New Zealand white rabbits at the origin of the right common carotid artery at the brachiocephalic trunk. Newly developed polymer coils in both groups for six aneurysms each and platinum coils for two aneurysms each were used. Control angiographies followed in both groups immediately after coiling as well as in the first eight animals 30 days after intervention (30 days group) and in the other eight animals 90 days after (90 days group). An explanation and histological evaluation of the treated aneurysms followed. RESULTS The 12 animals in which the aneurysms were treated with polymer coils showed a complete occlusion (grade IV) in only 6 out of 12 aneurysms (50%), an almost complete occlusion (grade III) in 5 out of 12 (42%) and an incomplete occlusion in the treatment of one aneurysm (8%). Histologically, we observed a significantly more pronounced inflammatory response and neoangiogenesis in aneurysms treated with polymer coils only in the 30 days group. CONCLUSION Most difficulties and concerns with the polymer coils were related to the flexibility and detachment behaviour. Therefore, and due to the technical challenges of delivery, the novel polymer coil cannot be considered an alternative to the current platinum coils.
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Affiliation(s)
- David-R Bisharat
- Clinic for Diagnostic and Interventional Neuroradiology of the Saarland University Hospital, Homburg, Germany
| | - Jed Johnson
- Nanofiber Solutions Inc., Columbus, Ohio, USA
| | - Ruben Mühl-Benninghaus
- Clinic for Diagnostic and Interventional Neuroradiology of the Saarland University Hospital, Homburg, Germany
| | - Toshiki Tomori
- Clinic for Diagnostic and Interventional Neuroradiology of the Saarland University Hospital, Homburg, Germany
| | - James Lago
- Phenox German Engineering GmbH, Bochum, Germany
| | - Renu Virmani
- CVPath Institute Inc., Gaithersburg, Maryland, USA
| | - Wolfgang Reith
- Clinic for Diagnostic and Interventional Neuroradiology of the Saarland University Hospital, Homburg, Germany
| | - Andreas Simgen
- Clinic for Diagnostic and Interventional Neuroradiology of the Saarland University Hospital, Homburg, Germany
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Won DS, Kim MH, Lee KB, Yoon JT, Park Y, Lee DH. A modified method of elastase-induced saccular aneurysm creation in rabbits: Schematic representation of the method. Interv Neuroradiol 2023; 29:548-554. [PMID: 35733403 PMCID: PMC10549710 DOI: 10.1177/15910199221109762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 06/01/2022] [Accepted: 06/08/2022] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND The purpose of our study was to investigate the safety and effectiveness of a modified technique using a short guiding catheter for instillation of elastase in comparison with the previously described method of creating elastase-induced aneurysm in rabbits. METHODS Following right common carotid artery (RCCA) access using an arterial sheath and inflating the Fogarty balloon in the subclavian artery, a short guiding catheter was used for the instillation of the elastase in the experimental group (n = 5) while it was performed with a microcatheter in the control group (n = 5). The procedure duration was recorded from the RCCA puncture to the sheath removal. The histological changes were characterized using H&E and Masson's trichrome (MT) staining. RESULTS The procedure time was 23 ± 2 min in the experimental group and 29 ± 2 min in the control group. All the rabbits (100%) in the experimental group survived without neurologic deficits, but two rabbits (40%) survived in the control group. All aneurysms were created in the saccular shape (100%) with a neck size of 2.3 ± 0.29 mm, a width of 2.75 ± 0.36 mm, and height of 6.37 ± 0.46 mm, and a dome to neck ratio of 1.21 ± 0.23. The aneurysm walls were partly thickened due to the degradation of the media tunica and adventitia proliferation with loss of the internal elastic lamina. CONCLUSION By using a short guiding catheter, we could instill the elastase in a more effective and safe manner in the creation of the elastase-induced aneurysm model in rabbits.
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Affiliation(s)
- Dong-Sung Won
- Biomedical Engineering Research Center, Asan Institute for Life Sciences, Asan Medical Center, Seoul, Republic of Korea
- Department of Radiology, Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Mi Hyeon Kim
- Biomedical Engineering Research Center, Asan Institute for Life Sciences, Asan Medical Center, Seoul, Republic of Korea
- Department of Radiology, Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Ki Baek Lee
- Department of Radiologic Technology, Chungbuk Health & Science University, Cheongju, Republic of Korea
| | - Jong Tae Yoon
- Biomedical Engineering Research Center, Asan Institute for Life Sciences, Asan Medical Center, Seoul, Republic of Korea
- Department of Radiology, Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Yubeen Park
- Biomedical Engineering Research Center, Asan Institute for Life Sciences, Asan Medical Center, Seoul, Republic of Korea
| | - Deok Hee Lee
- Department of Radiologic Technology, Chungbuk Health & Science University, Cheongju, Republic of Korea
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Cayron AF, Morel S, Allémann E, Bijlenga P, Kwak BR. Imaging of intracranial aneurysms in animals: a systematic review of modalities. Neurosurg Rev 2023; 46:56. [PMID: 36786880 PMCID: PMC9928939 DOI: 10.1007/s10143-023-01953-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 11/28/2022] [Accepted: 01/23/2023] [Indexed: 02/15/2023]
Abstract
Intracranial aneurysm (IA) animal models are paramount to study IA pathophysiology and to test new endovascular treatments. A number of in vivo imaging modalities are available to characterize IAs at different stages of development in these animal models. This review describes existing in vivo imaging techniques used so far to visualize IAs in animal models. We systematically searched for studies containing in vivo imaging of induced IAs in animal models in PubMed and SPIE Digital library databases between 1 January 1945 and 13 July 2022. A total of 170 studies were retrieved and reviewed in detail, and information on the IA animal model, the objective of the study, and the imaging modality used was collected. A variety of methods to surgically construct or endogenously induce IAs in animals were identified, and 88% of the reviewed studies used surgical methods. The large majority of IA imaging in animals was performed for 4 reasons: basic research for IA models, testing of new IA treatment modalities, research on IA in vivo imaging of IAs, and research on IA pathophysiology. Six different imaging techniques were identified: conventional catheter angiography, computed tomography angiography, magnetic resonance angiography, hemodynamic imaging, optical coherence tomography, and fluorescence imaging. This review presents and discusses the advantages and disadvantages of all in vivo IA imaging techniques used in animal models to help future IA studies finding the most appropriate IA imaging modality and animal model to answer their research question.
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Affiliation(s)
- Anne F Cayron
- Department of Pathology and Immunology, Faculty of Medicine, University of Geneva, Rue Michel-Servet 1, CH-1211, Geneva, Switzerland
- Geneva Center for Inflammation Research, Faculty of Medicine, University of Geneva, Geneva, Switzerland
- School of Pharmaceutical Sciences, University of Geneva, Geneva, Switzerland
- Institute of Pharmaceutical Sciences of Western Switzerland, University of Geneva, Geneva, Switzerland
| | - Sandrine Morel
- Department of Pathology and Immunology, Faculty of Medicine, University of Geneva, Rue Michel-Servet 1, CH-1211, Geneva, Switzerland
- Geneva Center for Inflammation Research, Faculty of Medicine, University of Geneva, Geneva, Switzerland
- Department of Clinical Neurosciences - Division of Neurosurgery, Geneva University Hospitals and Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Eric Allémann
- School of Pharmaceutical Sciences, University of Geneva, Geneva, Switzerland
- Institute of Pharmaceutical Sciences of Western Switzerland, University of Geneva, Geneva, Switzerland
| | - Philippe Bijlenga
- Department of Clinical Neurosciences - Division of Neurosurgery, Geneva University Hospitals and Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Brenda R Kwak
- Department of Pathology and Immunology, Faculty of Medicine, University of Geneva, Rue Michel-Servet 1, CH-1211, Geneva, Switzerland.
- Geneva Center for Inflammation Research, Faculty of Medicine, University of Geneva, Geneva, Switzerland.
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5
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Jang LK, Alvarado JA, Pepona M, Wasson EM, Nash LD, Ortega JM, Randles A, Maitland DJ, Moya ML, Hynes WF. Three-dimensional bioprinting of aneurysm-bearing tissue structure for endovascular deployment of embolization coils. Biofabrication 2020; 13. [DOI: 10.1088/1758-5090/abbb9b] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Accepted: 09/25/2020] [Indexed: 01/30/2023]
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An Effective and Simple Way to Establish Elastase-Induced Middle Carotid Artery Fusiform Aneurysms in Rabbits. BIOMED RESEARCH INTERNATIONAL 2020; 2020:6707012. [PMID: 32908904 PMCID: PMC7471820 DOI: 10.1155/2020/6707012] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Accepted: 07/28/2020] [Indexed: 11/25/2022]
Abstract
Objective Elastase-induced aneurysms in rabbits have been proposed as a preclinical tool for device development, but there is still much deficiency in those aneurismal models. So we need to explore the efficient and convenient animal models for the investigation of intracranial aneurysms. Then, we compared and analyzed three methods of elastase-induced carotid artery aneurysms in rabbits and aimed to find a simple, effective, and reproducible method for creating elastase-induced aneurysms. Methods 42 standard feeding male adult Japanese white rabbits (3.05 ± 0.65 kg) were randomly divided into 3 groups and treated with elastase ablation to create common carotid artery (RCCA) aneurysm models: Group A (root-RCCA medication group, n = 12), Group B (mid-RCCA medication group, n = 18), and Group C (ligated RCCA+medication group, n = 12). For Group A, the origin of the RCCA was blocked by two temporary aneurysm clips, and the resulting 2 cm cavity was infused with elastase for 20 min, then the clip was removed and the RCCA was not ligated. For Group B, the middle part of RCCA was treated the same way as Group A and the RCCA was not ligated. For Group C, the middle part of RCCA was treated as Group B, but the distal RCCA was ligated. After the aneurysm models were created for 3 weeks, prior to sacrificing the animals, color Doppler ultrasound and angiography were performed for blood flow measurements inside the aneurysms. Histological analysis (such as SMA-α, CD31, CD34, CD68, collagen IV, and Ki67) and the other relevant indexes were compared between the ideal model's aneurysmal tissues and the human intracranial aneurysm's tissues to confirm whether we have successfully established elastase-induced aneurysm models. Results Compared with human intracranial aneurysm specimens by the color Doppler ultrasound, angiography, and changes in the inner diameter of arteries, all three methods have successfully established the elastase-induced aneurysm models. Histology showed that biological responses were similar to both human cerebral aneurysms and previously published elastase-induced rabbit aneurysm models. Group A and Group B had the same morphology, but Group A had a higher mortality rate than Group B. Group B and Group C had different morphology. The aneurysm of Group C was more similar to human cerebral aneurysms but had a higher mortality rate than Group B. Group B was confirmed not only as an alternative method but also as a more safe and effective method for creating elastase-induced aneurysm models. Conclusion Through analysis and comparison, the Group B is proven to be the simplest, reproducible, and most effective modeling method. The aneurysm model established by Group B can be used for basic research related to aneurysm mechanism. We have provided a new and effective method for basic research on aneurysm.
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Camstra KM, Srinivasan VM, Collins D, Chen S, Kan P, Johnson J. Canine Model for Selective and Superselective Cerebral Intra-Arterial Therapy Testing. Neurointervention 2020; 15:107-116. [PMID: 32777874 PMCID: PMC7608496 DOI: 10.5469/neuroint.2020.00150] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Accepted: 06/22/2020] [Indexed: 12/21/2022] Open
Abstract
PURPOSE With advancing endovascular technology and increasing interest in minimally invasive intra-arterial therapies such as stem cell and chemotherapy for cerebral disease, the establishment of a translational model with cerebral circulation accessible to microcatheters is needed. We report our experience catheterizing canine cerebral circulation with microcatheters, present high-resolution angiographic images of the canine vascular anatomy, describe arterial branch flow patterns and provide measurements of canine arterial conduits. MATERIALS AND METHODS Angiograms were performed on 10 intact purpose-bred hounds. Angiography, measurements of arterial conduits and catheterization information for intracranial arterial branches were obtained. RESULTS Selective and superselective cerebral angiography was successful in all subjects. Relevant arterial mean diameters include the femoral (4.64 mm), aorta (9.38 mm), external carotid (3.65 mm), internal carotid arteries (1.6 mm), vertebrobasilar system and Circle of Willis branches. Catheterization of the Circle of Willis was achieved via the posterior circulation in all subjects tested (n=3) and the use of flow directed microcatheters resulted in reduced arterial tree deformation and improved superselection of intracranial vessels. Catheterization of the intracranial circulation was attempted but not achieved via the internal carotid artery (n=7) due to its tortuosity and subsequent catheter related vasospasm. CONCLUSION The canine cerebral vasculature is posterior circulation dominant. Anterior circulation angiography is achievable via the internal carotid artery, but direct cerebral arterial access is best achieved via the posterior circulation using flow-directed microcatheters. It is feasible to deliver intra-arterial therapies to selective vascular territories within the canine cerebral circulation, thus making it a viable animal model for testing novel intra-arterial cerebral treatments.
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Affiliation(s)
- Kevin M Camstra
- Department of Neurosurgery, Baylor College of Medicine, Houston, TX, USA
| | | | - Dalis Collins
- Department of Surgery, Baylor College of Medicine, Houston, TX, USA.,Center for Comparative Medicine, Baylor College of Medicine, Houston, TX, USA
| | - Stephen Chen
- Department of Radiology, Baylor College of Medicine, Houston, TX, USA
| | - Peter Kan
- Department of Neurosurgery, Baylor College of Medicine, Houston, TX, USA
| | - Jeremiah Johnson
- Department of Neurosurgery, Baylor College of Medicine, Houston, TX, USA
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8
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Tang H, Lu Z, Xue G, Li S, Xu F, Yan Y, Liu J, Zuo Q, Luo Y, Huang Q. The development and understanding of intracranial aneurysm based on rabbit model. Neuroradiology 2020; 62:1219-1230. [PMID: 32594185 DOI: 10.1007/s00234-020-02475-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Accepted: 06/10/2020] [Indexed: 10/24/2022]
Abstract
In modern society, intracranial aneurysms have seriously affected people's life. To better study and treat intracranial aneurysm, animal models are ideal candidates to perform biological research and preclinical endovascular device testing. Rabbit aneurysm model is one of the most commonly used animal models, and the rabbit aneurysms share similarities in histology, morphology, and hemodynamic aspects with human intracranial aneurysms, which is an ideal model for intracranial aneurysm pre-clinical and basic research. In this review, we will summarize the main methods of establishing rabbit aneurysms model and will further discuss the current biological mechanisms of intracranial aneurysms based on rabbit model. Further improvements of rabbit aneurysm model and more deep studies based on this model are needed to provide new insights into studying and clinical treating intracranial aneurysm.
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Affiliation(s)
- Haishuang Tang
- Department of Neurosurgery, Changhai Hospital, Second Military Medical University, Shanghai, 200433, People's Republic of China.,Naval Medical Center of PLA, Second Military Medical University, Shanghai, 200050, People's Republic of China
| | - Zhiwen Lu
- Department of Neurosurgery, Changhai Hospital, Second Military Medical University, Shanghai, 200433, People's Republic of China
| | - Gaici Xue
- Department of Neurosurgery, Changhai Hospital, Second Military Medical University, Shanghai, 200433, People's Republic of China
| | - Sisi Li
- Department of Neurosurgery, Changhai Hospital, Second Military Medical University, Shanghai, 200433, People's Republic of China
| | - Fengfeng Xu
- Naval Medical Center of PLA, Second Military Medical University, Shanghai, 200050, People's Republic of China
| | - Yazhou Yan
- Department of Neurosurgery, Changhai Hospital, Second Military Medical University, Shanghai, 200433, People's Republic of China
| | - Jianmin Liu
- Department of Neurosurgery, Changhai Hospital, Second Military Medical University, Shanghai, 200433, People's Republic of China
| | - Qiao Zuo
- Department of Neurosurgery, Changhai Hospital, Second Military Medical University, Shanghai, 200433, People's Republic of China
| | - Yin Luo
- Department of Neurosurgery, Changhai Hospital, Second Military Medical University, Shanghai, 200433, People's Republic of China
| | - Qinghai Huang
- Department of Neurosurgery, Changhai Hospital, Second Military Medical University, Shanghai, 200433, People's Republic of China.
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Marbacher S, Strange F, Frösén J, Fandino J. Preclinical extracranial aneurysm models for the study and treatment of brain aneurysms: A systematic review. J Cereb Blood Flow Metab 2020; 40:922-938. [PMID: 32126875 PMCID: PMC7181093 DOI: 10.1177/0271678x20908363] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Animal models make an important contribution to our basic understanding of the pathobiology of human brain aneurysms, are indispensable in testing novel treatment approaches, and are essential for training interventional neuroradiologists and neurosurgeons. Researchers are confronted with a broad diversity of models and techniques in various species. This systematic review aims to summarize and categorize extracranial aneurysm models and their characteristics, discuss advantages and disadvantages, and suggest the best use of each model. We searched the electronical Medline/PubMed database between 1950 and 2020 to identify main models and their refinements and technical modifications for creation of extracranial aneurysms. Each study included was assessed for aneurysm-specific characteristics, technical details of aneurysm creation, and histological findings. Among more than 4000 titles and abstracts screened, 473 studies underwent full-text analysis. From those, 68 different techniques/models in five different species were identified, analyzed in detail, and then grouped into one of the five main groups of experimental models as sidewall, terminal, stump, bifurcation, or complex aneurysm models. This systematic review provides a compact guide for investigators in selecting the most appropriate model from a range of techniques to best suit their experimental goals, practical considerations, and laboratory environment.
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Affiliation(s)
- Serge Marbacher
- Department of Neurosurgery, Kantonsspital Aarau, Aarau, Switzerland.,Cerebrovascular Research Group, Department for BioMedical Research, University of Bern, Bern, Switzerland
| | - Fabio Strange
- Department of Neurosurgery, Kantonsspital Aarau, Aarau, Switzerland.,Cerebrovascular Research Group, Department for BioMedical Research, University of Bern, Bern, Switzerland
| | - Juhana Frösén
- Hemorrhagic Brain Pathology Research Group, Department of Neurosurgery, University of Tampere and Tampere University Hospital, Tampere, Finland
| | - Javier Fandino
- Department of Neurosurgery, Kantonsspital Aarau, Aarau, Switzerland.,Cerebrovascular Research Group, Department for BioMedical Research, University of Bern, Bern, Switzerland
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10
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Lefevre E, Rogers A. Carotid artery vein-pouch bifurcation aneurysm in rats: An experimental model for microneurosurgical training. Neurochirurgie 2020; 66:183-188. [PMID: 32277998 DOI: 10.1016/j.neuchi.2020.02.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2019] [Revised: 01/12/2020] [Accepted: 02/18/2020] [Indexed: 11/19/2022]
Abstract
BACKGROUND In the era of endovascular treatment of intracranial aneurysms, surgical clipping is still a relevant treatment method in some cases. However, it has become harder to teach this skill, as the number of surgical cases has decreased over the past years. We therefore decided to use a previously described experimental aneurysm model for surgical training. MATERIAL AND METHODS We operated on 8 rats and constructed a vein-pouch aneurysm at a surgically created carotid bifurcation. Survivors were kept alive for 1 month and operated on to clip the aneurysm. RESULTS Only 3 rats had survived at 1 month. All the carotid arteries were permeable. Only 2 aneurysms were circulating at 1 month, as 1 had thrombosed. They were successfully clipped at 1 month. CONCLUSIONS These preliminary results enabled our junior surgeon to clip two circulating aneurysms, under an operative microscope reproducing surgical conditions. Although the efficacy of the model could be improved, we believe it could be used as a first step in training neurosurgical residents in the basics of aneurysm clipping and microsurgical techniques in a realistic setting.
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Affiliation(s)
- E Lefevre
- Department of Neurosurgery, hôpital universitaire Pitié Salpêtrière, Paris, France.
| | - A Rogers
- Department of Neurosurgery, fondation ophtalmologique Adolphe-de-Rothschild, Paris, France.
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Thompson JW, Elwardany O, McCarthy DJ, Sheinberg DL, Alvarez CM, Nada A, Snelling BM, Chen SH, Sur S, Starke RM. In vivo cerebral aneurysm models. Neurosurg Focus 2019; 47:E20. [DOI: 10.3171/2019.4.focus19219] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Accepted: 04/09/2019] [Indexed: 11/06/2022]
Abstract
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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Affiliation(s)
- John W. Thompson
- Departments of 1Neurological Surgery and
- 3The University of Miami Cerebrovascular Initiative, University of Miami; and
| | - Omar Elwardany
- Departments of 1Neurological Surgery and
- 3The University of Miami Cerebrovascular Initiative, University of Miami; and
| | - David J. McCarthy
- Departments of 1Neurological Surgery and
- 3The University of Miami Cerebrovascular Initiative, University of Miami; and
| | - Dallas L. Sheinberg
- Departments of 1Neurological Surgery and
- 3The University of Miami Cerebrovascular Initiative, University of Miami; and
| | - Carlos M. Alvarez
- Departments of 1Neurological Surgery and
- 3The University of Miami Cerebrovascular Initiative, University of Miami; and
| | - Ahmed Nada
- Departments of 1Neurological Surgery and
- 3The University of Miami Cerebrovascular Initiative, University of Miami; and
| | - Brian M. Snelling
- Departments of 1Neurological Surgery and
- 3The University of Miami Cerebrovascular Initiative, University of Miami; and
- 4Marcus Neuroscience Institute, Boca Raton Regional Hospital, Boca Raton, Florida
| | - Stephanie H. Chen
- Departments of 1Neurological Surgery and
- 3The University of Miami Cerebrovascular Initiative, University of Miami; and
| | - Samir Sur
- Departments of 1Neurological Surgery and
- 3The University of Miami Cerebrovascular Initiative, University of Miami; and
| | - Robert M. Starke
- Departments of 1Neurological Surgery and
- 2Radiology, University of Miami
- 3The University of Miami Cerebrovascular Initiative, University of Miami; and
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12
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Simgen A, Tomori T, Bomberg H, Yilmaz U, Roth C, Reith W, Mühl-Bennighaus R. Intravenous versus intra-arterial digital subtraction angiography: Occlusion rate and complication assessment of experimental aneurysms after flow diverter treatment in rabbits. Interv Neuroradiol 2019; 25:157-163. [PMID: 30394843 PMCID: PMC6448376 DOI: 10.1177/1591019918808537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2018] [Accepted: 10/02/2018] [Indexed: 11/15/2022] Open
Abstract
PURPOSE Conventional intra-arterial digital subtraction angiography, which requires surgical exposure and ligation of the femoral or carotid artery, is a limited method of evaluating elastase-induced aneurysms in New Zealand white rabbits. The purpose of this study was to assess aneurysm morphology, occlusion rates and complications after flow diverter treatment comparing intravenous and intra-arterial digital subtraction angiography. METHODS We previously published a preclinical study in which we evaluated the occlusion rates of elastase-induced aneurysms after treatment with a prototype flow diverter, by using intra-arterial digital subtraction angiography at three months ( n = 9) and six months ( n = 9). In addition to that intravenous digital subtraction angiography before treatment, after one month (early follow-up group) and after three months (late follow-up group) was performed. Occlusion rates were compared within the two groups by means of residual contrast filling. RESULTS Baseline aneurysm characteristics revealed no significant differences between intra-arterial digital subtraction angiography and intravenous digital subtraction angiography. Aneurysm occlusion rates in both follow-up groups using intravenous digital subtraction angiography were significantly higher compared to intra-arterial digital subtraction angiography (early follow-up group: intravenous digital subtraction angiography (one month) versus intra-arterial digital subtraction angiography (three months); p = 0.03 and late follow-up group: intravenous digital subtraction angiography (three months) versus intra-arterial digital subtraction angiography (six months); p = 0.04). Intravenous digital subtraction angiography is feasible to detect and reproduce device occlusions, in-stent stenosis and post-stent stenosis. CONCLUSION Intravenous digital subtraction angiography can not give a sufficient statement on the aneurysm occlusion process compared to intra-arterial digital subtraction angiography and is therefore not recommended for imaging follow-up after flow diverter treatment in rabbits. Regarding untreated aneurysms and complications like device occlusions, in-stent stenosis and post-stent stenosis intravenous digital subtraction angiography proofed to be a good alternative to intra-arterial digital subtraction angiography in our study.
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Affiliation(s)
- Andreas Simgen
- Department of Neuroradiology, Saarland University Hospital, Homburg/Saar, Germany
| | - Toshiki Tomori
- Department of Neuroradiology, Saarland University Hospital, Homburg/Saar, Germany
| | - Hagen Bomberg
- Department of Anesthesiology, Saarland University Hospital, Homburg/Saar, Germany
| | - Umut Yilmaz
- Department of Neuroradiology, Saarland University Hospital, Homburg/Saar, Germany
| | - Christian Roth
- Department of Neuroradiology, Clinic Bremen-Mitte, Bremen, Germany
| | - Wolfgang Reith
- Department of Neuroradiology, Saarland University Hospital, Homburg/Saar, Germany
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Shen TW, Puccini B, Temnyk K, Herting S, Cardinal KO. Tissue-engineered aneurysm models for in vitro assessment of neurovascular devices. Neuroradiology 2019; 61:723-732. [DOI: 10.1007/s00234-019-02197-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Accepted: 03/07/2019] [Indexed: 12/14/2022]
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Kolumam Parameswaran P, Dai D, Ding YH, Gunderson T, Kallmes DF, Kadirvel R. Assessment of endothelialization of aneurysm wall over time in a rabbit model through CD31 scoring. J Neurointerv Surg 2017; 10:888-891. [PMID: 29288193 DOI: 10.1136/neurintsurg-2017-013381] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2017] [Revised: 11/30/2017] [Accepted: 12/01/2017] [Indexed: 01/27/2023]
Abstract
BACKGROUND Intracranial aneurysms represent a significant health concern and are poorly understood despite decades of research. Our study focused on understanding temporal patterns of endothelial cell distribution in different spatial locations within the aneurysm early after creation in a rabbit model. METHODS Elastase induced saccular aneurysms were created in rabbits and harvested on day 1 (n=3) and after 2 (n=5), 4 (n=4), 8 (n=5), and 12 (n=6) weeks. Sham operated controls (n=3) were harvested on the same day. Aneurysm and control tissue samples were subjected to en face whole mount CD31 staining for endothelial cells. Semiquantitative scoring was performed on the basis of endothelial coverage of the vessel wall (proximal, middle, and distal portions of the aneurysm dome). Mixed effects models were used to assess the effect of time and aneurysm section on endothelial coverage. RESULTS Aneurysmal segments were near completely de-endothelialized at 4 and 8 weeks but had re-endothelialized by 12 weeks. Compared with controls, aneurysms at all time points showed decreased endothelialization, but the difference was only significant compared with the 4 and 8 week groups. Both time (P=0.03) and aneurysm section (P=0.07) were significantly associated with the degree of endothelialization. Proximal locations showed increased endothelialization compared with distal locations (P=0.03). CONCLUSION In experimental aneurysms of rabbits, endothelial cells regress during the first month after creation, followed by ascending re-endothelialization that stays incomplete. These findings suggest that re-population of endothelial cells comes from resident cells in the adjacent parent artery and that deranged hemodynamics may affect full reconstitution of endothelial cells long term.
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Affiliation(s)
| | - Daying Dai
- Department of Radiology, Mayo Clinic, Rochester, Minnesota, USA
| | - Yong-Hong Ding
- Department of Radiology, Mayo Clinic, Rochester, Minnesota, USA
| | - Tina Gunderson
- Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, Minnesota, USA
| | - David F Kallmes
- Department of Radiology, Mayo Clinic, Rochester, Minnesota, USA
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Jiang G, Li Z, Jiang X, Li Z, Xu S, Fang X. Development of fusiform aneurysms induced by topical application of elastase in a rabbit model. Chin Neurosurg J 2017. [DOI: 10.1186/s41016-017-0093-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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16
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Nash LD, Browning Monroe MB, Ding YH, Ezell KP, Boyle AJ, Kadirvel R, Kallmes DF, Maitland DJ. Increased X-ray Visualization of Shape Memory Polymer Foams by Chemical Incorporation of Iodine Motifs. Polymers (Basel) 2017; 9. [PMID: 30034862 PMCID: PMC6052870 DOI: 10.3390/polym9080381] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
Shape memory polymers can be programmed into a secondary geometry and recovered to their primary geometry with the application of a controlled stimulus. Porous shape memory polymer foam scaffolds that respond to body temperature show particular promise for embolic medical applications. A limitation for the minimally invasive delivery of these materials is an inherent lack of X-ray contrast. In this work, a triiodobenzene containing a monomer was incorporated into a shape memory polymer foam material system to chemically impart X-ray visibility and increase material toughness. Composition and process changes enabled further control over material density and thermomechanical properties. The proposed material system demonstrates a wide range of tailorable functional properties for the design of embolic medical devices, including X-ray visibility, expansion rate, and porosity. Enhanced visualization of these materials can improve the acute performance of medical devices used to treat vascular malformations, and the material porosity provides a healing scaffold for durable occlusion.
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Affiliation(s)
- Landon D. Nash
- Biomedical Engineering, Texas A&M University, College Station, TX 77843, USA; (L.D.N.); (M.B.B.M.); (K.P.E.); (A.J.B.)
| | - Mary Beth Browning Monroe
- Biomedical Engineering, Texas A&M University, College Station, TX 77843, USA; (L.D.N.); (M.B.B.M.); (K.P.E.); (A.J.B.)
| | - Yong-Hong Ding
- Department of Radiology, Mayo Clinic, Rochester, MN 55905, USA; (Y.-H.D.); (R.K.); (D.F.K.)
| | - Kendal P. Ezell
- Biomedical Engineering, Texas A&M University, College Station, TX 77843, USA; (L.D.N.); (M.B.B.M.); (K.P.E.); (A.J.B.)
| | - Anthony J. Boyle
- Biomedical Engineering, Texas A&M University, College Station, TX 77843, USA; (L.D.N.); (M.B.B.M.); (K.P.E.); (A.J.B.)
| | - Ramanathan Kadirvel
- Department of Radiology, Mayo Clinic, Rochester, MN 55905, USA; (Y.-H.D.); (R.K.); (D.F.K.)
| | - David F. Kallmes
- Department of Radiology, Mayo Clinic, Rochester, MN 55905, USA; (Y.-H.D.); (R.K.); (D.F.K.)
| | - Duncan J. Maitland
- Biomedical Engineering, Texas A&M University, College Station, TX 77843, USA; (L.D.N.); (M.B.B.M.); (K.P.E.); (A.J.B.)
- Correspondence: ; Tel.: +1-979-458-3471
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Fahed R, Darsaut TE, Salazkin I, Gentric JC, Mazighi M, Raymond J. Testing Stenting and Flow Diversion Using a Surgical Elastase-Induced Complex Fusiform Aneurysm Model. AJNR Am J Neuroradiol 2016; 38:317-322. [PMID: 27884881 DOI: 10.3174/ajnr.a5018] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2016] [Accepted: 09/29/2016] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Rabbit elastase-induced saccular aneurysms have been commonly used for preclinical testing of endovascular devices, including flow diverters. However, all tested devices have been shown to be capable of aneurysm occlusion with this model. We aimed to create a more challenging model to test and discriminate among neurovascular devices of varying efficacies. MATERIALS AND METHODS With a surgical approach that included elastase infusion and balloon dilation, we attempted the creation of complex fusiform aneurysms in 16 rabbits, with standard saccular carotid aneurysms created in 15 other animals. Aneurysms were randomly allocated to one of the following treatments: flow diversion (n = 8), high-porosity stent (n = 6), double high-porosity stent (n = 5), and control (n = 6). Angiographic assessment and pathologic analyses were performed at 3 months. RESULTS Creation of complex fusiform and standard saccular aneurysms was successful in 12/16 and 13/15 attempts, respectively. All saccular (n = 4) or complex fusiform (n = 4) aneurysms treated with flow diverters were successfully occluded. Three of 3 saccular compared with 0/2 complex fusiform aneurysms were occluded by double high-porosity stents. One of 3 saccular and 0/3 complex fusiform aneurysms were occluded by a single high-porosity stent. Both aneurysm types shared the same pathologic findings when untreated: The aneurysm wall lacked an elastic layer and smooth muscle cells, while the lumen was lined with neointima of varying thickness. Neointimal coverage of the devices was complete when aneurysms were occluded, while leaks were always associated with aneurysm remnants. CONCLUSIONS Challenging fusiform aneurysms can be created in rabbits by using a surgical modification of the elastase method.
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Affiliation(s)
- R Fahed
- From the Centre Hospitalier de l'Université de Montréal (R.F., I.S., J.R.), Interventional Neuroradiology Research Laboratory, Notre-Dame Hospital, Montreal, Quebec, Canada
| | - T E Darsaut
- Department of Surgery (T.E.D.), Division of Neurosurgery, University of Alberta Hospital, Mackenzie Health Sciences Centre, Edmonton, Alberta, Canada
| | - I Salazkin
- From the Centre Hospitalier de l'Université de Montréal (R.F., I.S., J.R.), Interventional Neuroradiology Research Laboratory, Notre-Dame Hospital, Montreal, Quebec, Canada
| | - J-C Gentric
- Department of Radiology (J.-C.G.), Division of Neuroradiology, Centre Hospitalo-Universitaire Cavale Blanche, Brest, France
| | - M Mazighi
- Department of Interventional Neuroradiology (M.M.), Fondation Ophtalmologique Adolphe de Rothschild, Paris, France
| | - J Raymond
- From the Centre Hospitalier de l'Université de Montréal (R.F., I.S., J.R.), Interventional Neuroradiology Research Laboratory, Notre-Dame Hospital, Montreal, Quebec, Canada
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Simgen A, Ley D, Roth C, Cattaneo GFM, Mühl-Benninghaus R, Müller A, Körner H, Kim YJ, Scheller B, Reith W, Yilmaz U. Evaluation of occurring complications after flow diverter treatment of elastase-induced aneurysm in rabbits using micro-CT and MRI at 9.4 T. Neuroradiology 2016; 58:987-996. [DOI: 10.1007/s00234-016-1730-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2016] [Accepted: 07/12/2016] [Indexed: 12/22/2022]
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Brinjikji W, Yong Hong D, Dai D, Schroeder DJ, Kallmes DF, Kadirvel R. Statins are not associated with short-term improved aneurysm healing in a rabbit model of unruptured aneurysms. J Neurointerv Surg 2016; 9:200-203. [DOI: 10.1136/neurintsurg-2016-012265] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2016] [Revised: 02/01/2016] [Accepted: 02/04/2016] [Indexed: 11/04/2022]
Abstract
BackgroundOwing to their anti-inflammatory effects and ability to stimulate production of extracellular matrix and chemotactic migration of mesenchymal progenitor cells, statins could potentially improve aneurysm healing after endovascular treatment.ObjectiveTo test the hypothesis that systemic administration of simvastatin would improve aneurysm healing in a rabbit model of unruptured intracranial aneurysms.MethodsExperimental aneurysms were created in female rabbits and were embolized with platinum coils. Six rabbits served as controls and six rabbits received oral administration of simvastatin. Digital subtraction angiography was used to evaluate stability after embolization. Subjects were euthanized 4 weeks after coil embolization. Histologic samples were examined with a grading system (0–12) based on neck and dome features. Aneurysm occlusion data were compared using a Student t test.ResultsNo significant differences in the mean aneurysm size were found between groups. No coil compaction occurred in either group. All aneurysms in both the statin and control groups showed stable occlusion. There were no significant differences in the histologic grade of occlusion in either group (statin group 2.6±0.8 vs control group 2.7±3.2, p=0.94).ConclusionsSystemic statin administration after platinum coil embolization of unruptured aneurysms in a rabbit model does not improve aneurysm occlusion rates at 4 weeks.
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Ley D, Mühl-Benninghaus R, Yilmaz U, Körner H, Cattaneo GFM, Mailänder W, Kim YJ, Scheller B, Reith W, Simgen A. The Derivo Embolization Device, a Second-Generation Flow Diverter for the Treatment of Intracranial Aneurysms, Evaluated in an Elastase-Induced Aneurysm Model. Clin Neuroradiol 2015; 27:335-343. [DOI: 10.1007/s00062-015-0493-9] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2015] [Accepted: 12/09/2015] [Indexed: 11/30/2022]
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Ott S, Gölitz P, Adamek E, Royalty K, Doerfler A, Struffert T. Flat-detector computed tomography evaluation in an experimental animal aneurysm model after endovascular treatment: A pilot study. Interv Neuroradiol 2015; 21:490-8. [PMID: 26111985 DOI: 10.1177/1591019915590364] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
We compared flat-detector computed tomography angiography (FD-CTA) to multislice computed tomography (MS-CTA) and digital subtracted angiography (DSA) for the visualization of experimental aneurysms treated with stents, coils or a combination of both.In 20 rabbits, aneurysms were created using the rabbit elastase aneurysm model. Seven aneurysms were treated with coils, seven with coils and stents, and six with self-expandable stents alone. Imaging was performed by DSA, MS-CTA and FD-CTA immediately after treatment. Multiplanar reconstruction (MPR) was performed and two experienced reviewers compared aneurysm/coil package size, aneurysm occlusion, stent diameters and artifacts for each modality.In aneurysms treated with stents alone, the visualization of the aneurysms was identical in all three imaging modalities. Residual aneurysm perfusion was present in two cases and visible in DSA and FD-CTA but not in MS-CTA. The diameter of coil-packages was overestimated in MS-CT by 56% and only by 16% in FD-CTA compared to DSA (p < 0.05). The diameter of stents was identical for DSA and FD-CTA and was significantly overestimated in MS-CTA (p < 0.05). Beam/metal hardening artifacts impaired image quality more severely in MS-CTA compared to FD-CTA.MS-CTA is impaired by blooming and beam/metal hardening artifacts in the visualization of implanted devices. There was no significant difference between measurements made with noninvasive FD-CTA compared to gold standard of DSA after stenting and after coiling/stent-assisted coiling of aneurysms. FD-CTA may be considered as a non-invasive alternative to the gold standard 2D DSA in selected patients that require follow up imaging after stenting.
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Affiliation(s)
- Sabine Ott
- Department of Neuroradiology, University of Erlangen-Nuremberg, Germany
| | - Philipp Gölitz
- Department of Neuroradiology, University of Erlangen-Nuremberg, Germany
| | - Edyta Adamek
- Department of Neuroradiology, University of Erlangen-Nuremberg, Germany
| | - Kevin Royalty
- Department of Biomedical Engineering and School of Medicine and Public Health, University of Wisconsin, USA
| | - Arnd Doerfler
- Department of Neuroradiology, University of Erlangen-Nuremberg, Germany
| | - Tobias Struffert
- Department of Neuroradiology, University of Erlangen-Nuremberg, Germany
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Krähenbühl AK, Gralla J, Abu-Isa J, Mordasini P, Widmer HR, Raabe A, Reinert M. High-flow venous pouch aneurysm in the rabbit carotid artery: A model for large aneurysms. Interv Neuroradiol 2015; 21:407-11. [PMID: 26015528 DOI: 10.1177/1591019915582381] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND AND PURPOSE Currently one of the most widely used models for the development of endovascular techniques and coiling devices for treatment of aneurysm is the elastase-induced aneurysm model in the rabbit carotid artery. Microsurgical techniques for creating an aneurysm with a venous pouch have also been established, although both techniques usually result in aneurysms less than 1 cm in diameter. We investigated whether an increase in blood flow toward the neck would produce larger aneurysms in a microsurgical venous pouch model. MATERIALS AND METHODS Microsurgical operations were performed on 11 New Zealand white rabbits. Both carotid arteries and the right jugular vein were dissected, and the right carotid artery was temporarily clipped followed by an arteriotomy. The left carotid artery was also clipped proximally, ligated distally, and sutured onto the proximal half of the arteriotomy in the right carotid artery. The venous graft was sutured onto the distal half of the arteriotomy. Digital subtraction angiography was also performed. RESULTS Angiography showed patent anastomosed vessels and aneurysms in the seven surviving rabbits. Mean aneurysm measurements among surviving rabbits with patent vessels were: 13.9 mm length, 9.3 mm width, and neck diameter 4.7 mm. The resulting mean aspect ratio was 3.35 and the mean bottleneck ratio was 3.05. CONCLUSION A large venous graft and increased blood flow toward the base of the aneurysm seem to be key factors in the creation of large venous pouch aneurysms. These large aneurysms allow testing of endovascular devices designed for large and giant aneurysms.
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Affiliation(s)
| | - Jan Gralla
- Institute for Neuroradiology, Bern University Hospital, Switzerland
| | - Janine Abu-Isa
- Department of Neurosurgery, Bern University Hospital, Switzerland
| | | | - Hans R Widmer
- Department of Neurosurgery, Bern University Hospital, Switzerland
| | - Andreas Raabe
- Department of Neurosurgery, Bern University Hospital, Switzerland
| | - Michael Reinert
- Department of Neurosurgery, Ospedale Civico di Lugano, Switzerland
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Evaluation of a newly designed flow diverter for the treatment of intracranial aneurysms in an elastase-induced aneurysm model, in New Zealand white rabbits. Neuroradiology 2014; 56:129-37. [PMID: 24496551 DOI: 10.1007/s00234-014-1320-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
INTRODUCTION In this study, we analyzed angiographic and histologic aneurysm occlusion of a newly designed flow diverting device. Visibility and flexibility, as well as occlusions of side branches and neointimal proliferation were also evaluated. METHODS Aneurysms were induced in 18 New Zealand white rabbits and treated with a braided, “closed-loop-designed” device of nitinol. Additional devices were implanted in the abdominal aorta to cover the origin of branch arteries.Angiographic follow-ups were performed immediately after placement of the device, after 3 months (n=9) and 6 months(n =9). The status of aneurysm occlusion (using a five-point scale) and the patency of branch arteries were assessed. RESULTS Aneurysm occlusion rates were noted as grade 0 in 2 (11 %), grade I in 1 (6 %), grade II in 1 (6 %), grade III in 9(50 %), and grade IV in 5 (28 %) of 18 aneurysms, respectively, indicating a complete or near-complete occlusion of 78 % under double antiplatelet therapy. Aneurysm occlusion was significantly higher at 6 months follow-up (P =0.025). Radiopaque markers provided excellent visibility. Limited device flexibility led to incomplete aneurysm neck coverage and grade 0 occlusion rates in two cases. Distal device occlusions were found in three cases, most likely due to an extremely undersized vessel diameter in the subclavian artery.No case of branch artery occlusion was seen. Intimal proliferation and diameter stenosis were moderate. CONCLUSION The tested flow diverter achieved near-complete and complete aneurysm occlusion under double antiplatelet therapy of elastase-induced aneurysms in 78 %, while preserving branch arteries.
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Walcott BP, Peterson RT. Zebrafish models of cerebrovascular disease. J Cereb Blood Flow Metab 2014; 34:571-7. [PMID: 24517974 PMCID: PMC3982096 DOI: 10.1038/jcbfm.2014.27] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2013] [Revised: 12/27/2013] [Accepted: 01/07/2014] [Indexed: 12/18/2022]
Abstract
Perturbations in cerebral blood flow and abnormalities in blood vessel structure are the hallmarks of cerebrovascular disease. While there are many genetic and environmental factors that affect these entities through a heterogeneous group of disease processes, the ultimate final pathologic insult in humans is defined as a stroke, or damage to brain parenchyma. In the case of ischemic stroke, blood fails to reach its target destination whereas in hemorrhagic stroke, extravasation of blood occurs outside of the blood vessel lumen, resulting in direct damage to brain parenchyma. As these acute events can be neurologically devastating, if not fatal, development of novel therapeutics are urgently needed. The zebrafish (Danio rerio) is an attractive model for the study of cerebrovascular disease because of its morphological and physiological similarity to human cerebral vasculature, its ability to be genetically manipulated, and its fecundity allowing for large-scale, phenotype-based screens.
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Affiliation(s)
- Brian P Walcott
- Department of Neurosurgery, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
- Cardiovascular Research Center, Massachusetts General Hospital and Harvard Medical School, Charlestown, Massachusetts, USA
| | - Randall T Peterson
- Cardiovascular Research Center, Massachusetts General Hospital and Harvard Medical School, Charlestown, Massachusetts, USA
- Broad Institute, Cambridge, Massachusetts, USA
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Sherif C, Kleinpeter G, Mach G, Loyoddin M, Haider T, Plasenzotti R, Bergmeister H, Di Ieva A, Gibson D, Krssak M. Evaluation of cerebral aneurysm wall thickness in experimental aneurysms: comparison of 3T-MR imaging with direct microscopic measurements. Acta Neurochir (Wien) 2014; 156:27-34. [PMID: 24170298 DOI: 10.1007/s00701-013-1919-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2013] [Accepted: 10/09/2013] [Indexed: 11/25/2022]
Abstract
BACKGROUND Thin aneurysm wall thickness (AWT) is thought to portend an elevated risk of intracranial aneurysm rupture. Magnetic resonance imaging (MRI) is biased by AWT overestimations. Previously, this suspected bias has been qualitatively described but never quantified. We aimed to quantify the overestimation of AWT by MRI when compared to the gold standard of AWT as measured by light microscopy of fresh aneurysm specimens (without any embedding procedure). This analysis should help to define the clinical potential of MRI estimates of AWT. METHODS 3-Tesla (3T) MRI (contrast-enhanced T1 Flash sequences; resolution: 0.4 x 0.4 x 1.5 mm(3)) was performed in 13 experimental aneurysms. After MR acquisition, the aneurysms were retrieved, longitudinally sectioned and calibrated micrographs were obtained immediately. AWT at the dome, AWT at the neck and parent vessel wall thickness (PVT) were measured on precisely correlated MR-images and histologic micrographs by blinded independent investigators. Parameters were statistically compared (Wilcoxon test, Spearman's correlation). RESULTS AWT was assessed and reliably measured using MRI. Interobserver variability was not significant for either method. MR overestimation was only significant below the image resolution threshold: AWT at the dome (0.24 ± 0.06 mm vs. MR 0.30 ± 0.08 mm; p = 0.0078; R = 0.6125), AWT at the neck (0.25 ± 0.07 mm vs. MR 0.29 ± 0.07 mm; p = 0.0469; R = 0.7451), PVT (0.46 ± 0.06 mm vs. MR 0.48 ± 0.06 mm; p = 0.5; R = 0.8568). CONCLUSION In this experimental setting, MR overestimations were minimal (mean 0.02 mm) above the image resolution threshold. When AWT is classified in ranges defined by the MR resolution threshold, clinical usage may be beneficial. Further quantitative and comparative experimental and human studies are warranted to confirm these findings.
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Affiliation(s)
- Camillo Sherif
- Department of Neurosurgery and Cerebrovascular Research Group, Krankenanstalt Rudolfstiftung, Juchgasse 25, A-1030, Vienna, Austria,
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Simgen A, Ley D, Roth C, Yilmaz U, Körner H, Mühl-Benninghaus R, Kim YJ, Scheller B, Reith W. Evaluation of a newly designed flow diverter for the treatment of intracranial aneurysms in an elastase-induced aneurysm model, in New Zealand white rabbits. Neuroradiology 2013; 56:129-137. [PMID: 24233131 DOI: 10.1007/s00234-013-1296-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2013] [Accepted: 10/21/2013] [Indexed: 10/26/2022]
Abstract
INTRODUCTION In this study, we analyzed angiographic and histologic aneurysm occlusion of a newly designed flow-diverting device. Visibility and flexibility, as well as occlusions of side branches and neointimal proliferation were also evaluated. METHODS Aneurysms were induced in 18 New Zealand white rabbits and treated with a braided, "closed-loop-designed" device of nitinol. Additional devices were implanted in the abdominal aorta to cover the origin of branch arteries. Angiographic follow-ups were performed immediately after placement of the device, after 3 months (n = 9) and 6 months (n = 9). The status of aneurysm occlusion (using a five-point scale) and the patency of branch arteries were assessed. RESULTS Aneurysm occlusion rates were noted as grade 0 in 2 (11 %), grade I in 1 (6 %), grade II in 1 (6 %), grade III in 9 (50 %), and grade IV in 5 (28 %) of 18 aneurysms, respectively, indicating a complete or near-complete occlusion of 78 % under double antiplatelet therapy. Aneurysm occlusion was significantly higher at 6 months follow-up (P = 0.025). Radiopaque markers provided excellent visibility. Limited device flexibility led to incomplete aneurysm neck coverage and grade 0 occlusion rates in two cases. Distal device occlusions were found in three cases, most likely due to an extremely undersized vessel diameter in the subclavian artery. No case of branch artery occlusion was seen. Intimal proliferation and diameter stenosis were moderate. CONCLUSION The tested flow diverter achieved near-complete and complete aneurysm occlusion under double antiplatelet therapy of elastase-induced aneurysms in 78 %, while preserving branch arteries.
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Affiliation(s)
- Andreas Simgen
- Department of Neuroradiology, Saarland University Hospital, Kirrberger Str., 66424, Homburg, Germany,
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Sherif C, Marbacher S, Fandino J. High-resolution three-dimensional 3 T magnetic resonance angiography for the evaluation of experimental aneurysm in the rabbit. Neurol Res 2013; 31:869-72. [PMID: 19215665 DOI: 10.1179/174313209x393979] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Affiliation(s)
- Camillo Sherif
- Department of Neurosurgery, Kantonsspital Aarau, Aarau, Switzerland
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Angiographic C-arm CT visualization of the Woven EndoBridge Cerebral Aneurysm Embolization Device (WEB): First Experience in an Animal Aneurysm Model. Clin Neuroradiol 2013; 24:43-9. [PMID: 23712863 DOI: 10.1007/s00062-013-0224-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2013] [Accepted: 04/30/2013] [Indexed: 10/26/2022]
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Namba K, Mashio K, Kawamura Y, Higaki A, Nemoto S. Swine hybrid aneurysm model for endovascular surgery training. Interv Neuroradiol 2013; 19:153-8. [PMID: 23693037 DOI: 10.1177/159101991301900202] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2012] [Accepted: 01/17/2013] [Indexed: 11/16/2022] Open
Abstract
The aim of this study was to develop a technically simple swine aneurysm-training model by inserting a silicone aneurysm circuit in the cervical vessels. A silicone aneurysm circuit was created by designing multiple aneurysms in size and configuration on a silicone vessel. Five swine underwent surgical implantation of this circuit in the cervical vessels: one end in the common carotid artery and the other in the external jugular vein. Using this model, an aneurysm coiling procedure was simulated under fluoroscopic guidance, roadmapping and digital subtraction angiography. Creating an aneurysm model for training purposes by this method was technically simple and enabled the formation of a wide variety of aneurysms in a single procedure. The quality of the model was uniform and the model was reproducible. Coiling training using this model resembled a realistic clinical situation. The swine hybrid aneurysm-training model was advantageous from the standpoint of technical simplicity in the creation and variety of aneurysms it provided. The swine hybrid aneurysm model may be an additional option for aneurysm coiling training.
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Affiliation(s)
- K Namba
- Department of Endovascular Surgery, Jichi Medical University; Tochigi, Japan.
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Ding YH, Tieu T, Kallmes DF. Creation of sidewall aneurysm in rabbits: aneurysm patency and growth follow-up. J Neurointerv Surg 2012; 6:29-31. [PMID: 23256990 DOI: 10.1136/neurintsurg-2012-010575] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
INTRODUCTION To explore the patency and growth of surgical sidewall aneurysms in rabbits. MATERIALS AND METHODS Forty sidewall aneurysms were created in the right common carotid artery (RCCA). Intravenous digital subtraction angiography (DSA) through the ear vein was performed immediately after creation. Three weeks later, intra-arterial DSA through the femoral artery was performed. Aneurysm sizes (neck, width, height and volume) were measured and calculated immediately after creation and 3 weeks later. Aneurysm patency after creation was evaluated. Differences in aneurysm sizes immediately after creation and 3 weeks later were compared using the Student's t test. RESULTS Aneurysms and the parent artery remained patent in 38 (95%) of the 40 rabbits 3 weeks after creation. Two other rabbits (5%) showed aneurysm occlusion. There was a significant difference in aneurysm neck size 3 weeks after creation (3.6±0.9 mm vs 2.4±0.4 mm, p<0.0001). The aneurysm became wider 3 weeks later (5.8±1.5 mm vs 4.3±1.2 mm, p<0.0001). Aneurysm length was also larger than immediately after creation (6.1±1.3 mm vs 4.3±1.4 mm, p<0.0001). The aneurysm volume was larger than that created immediately (127.5±89.4 mm(3) vs 51.0±34.9 mm(3), p<0.0001). CONCLUSIONS The patency rate of sidewall aneurysms in rabbits is high. The aneurysm keeps growing for at least 3 weeks after creation.
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Affiliation(s)
- Yong Hong Ding
- Department of Radiology, Neuroradiology Research Laboratory, Mayo Clinic, Rochester, Minnesota, USA
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Measurement of quantifiable parameters by time-density curves in the elastase-induced aneurysm model: first results in the comparison of a flow diverter and a conventional aneurysm stent. Eur Radiol 2012; 23:521-7. [PMID: 22895618 DOI: 10.1007/s00330-012-2611-2] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2012] [Revised: 07/01/2012] [Accepted: 07/13/2012] [Indexed: 10/28/2022]
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Endovascular broad-neck aneurysm creation in a porcine model using a vascular plug. Cardiovasc Intervent Radiol 2012; 36:239-44. [PMID: 22735890 DOI: 10.1007/s00270-012-0431-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2012] [Accepted: 05/20/2012] [Indexed: 10/28/2022]
Abstract
PURPOSE Ruptured cerebral arterial aneurysms require prompt treatment by either surgical clipping or endovascular coiling. Training for these sophisticated endovascular procedures is essential and ideally performed in animals before their use in humans. Simulators and established animal models have shown drawbacks with respect to degree of reality, size of the animal model and aneurysm, or time and effort needed for aneurysm creation. We therefore aimed to establish a realistic and readily available aneurysm model. MATERIALS AND METHODS Five anticoagulated domestic pigs underwent endovascular intervention through right femoral access. A total of 12 broad-neck aneurysms were created in the carotid, subclavian, and renal arteries using the Amplatzer vascular plug. RESULTS With dedicated vessel selection, cubic, tubular, and side-branch aneurysms could be created. Three of the 12 implanted occluders, two of them implanted over a side branch of the main vessel, did not induce complete vessel occlusion. However, all aneurysms remained free of intraluminal thrombus formation and were available for embolization training during a surveillance period of 6 h. Two aneurysms underwent successful exemplary treatment: one was stent-assisted, and one was performed with conventional endovascular coil embolization. CONCLUSION The new porcine aneurysm model proved to be a straightforward approach that offers a wide range of training and scientific applications that might help further improve endovascular coil embolization therapy in patients with cerebral aneurysms.
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Ysuda R, Strother CM, Aagaard-Kienitz B, Pulfer K, Consigny D. A large and giant bifurcation aneurysm model in canines: proof of feasibility. AJNR Am J Neuroradiol 2011; 33:507-12. [PMID: 22194362 DOI: 10.3174/ajnr.a2789] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE To our knowledge, no reproducible animal model of a giant bifurcation type aneurysm has been described. It was our aim to develop a 1-stage and reproducible model of a venous pouch giant aneurysm in canines. MATERIALS AND METHODS Nine canines were involved. Bilateral CCAs were exposed. The left CCA was divided and its distal segment was swung to the right side. Using the right CCA and the distal segment of the left CCA, either a bifurcation or a terminal arterial structure was constructed. Bilateral external jugular veins were also exposed. A 30-mm vein segment was harvested from each side. Each vein graft was split and unfolded to make 2 venous sheets. These sheets were then joined top-to-bottom so as to form a single cylinder in such a way that original adventitial side of the venous sheets was on the exterior surface. In 2 instances, pieces of polytetrafluoroethylene were employed along with the venous sheets. The combined vein graft was then incorporated into the arterial anastomosis. Lastly, the top of the venous pouch was closed. No medications for anticoagulant or antiplatelet were used throughout the study period. Follow-up imaging studies were performed. RESULTS It took 2.5 hours on average for 2 operators to create an aneurysm. Eight of the 9 aneurysms were patent at follow-up. The cause of the spontaneous thrombosis was unclear despite autopsy. All the aneurysms had a maximum diameter >20 mm. CONCLUSIONS We demonstrated and illustrated a 1-stage and reproducible procedure to create a model of a venous pouch bifurcation giant aneurysm in canines.
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Affiliation(s)
- R Ysuda
- Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin 53792-3252, USA
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Ding YH, Kadirvel R, Dai D, Kallmes DF. Creation of bifurcation-type elastase-induced aneurysms in rabbits. AJNR Am J Neuroradiol 2011; 34:E19-21. [PMID: 21903910 DOI: 10.3174/ajnr.a2666] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
SUMMARY Elastase incubation was performed in the LCCA in 13 New Zealand white rabbits. Three weeks after incubation, DSA demonstrated that 10 (10/13, 77%) bifurcation-type aneurysms at the origin of the LCCA were present; mean aneurysm neck, width, and height values were 3.7 ± 1.1, 3.8 ± 0.9, and 8.7 ± 2.3 mm, respectively. The LCCA can be used to create bifurcation aneurysms in rabbits.
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Affiliation(s)
- Y H Ding
- Neuroradiology Research Laboratory, Department of Radiology, Mayo Clinic, Rochester, Minnesota 55905, USA
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Struffert T, Ott S, Adamek E, Schwarz M, Engelhorn T, Kloska S, Deuerling-Zheng Y, Doerfler A. Flat-detector computed tomography in the assessment of intracranial stents: comparison with multi detector CT and conventional angiography in a new animal model. Eur Radiol 2011; 21:1779-87. [PMID: 21365196 DOI: 10.1007/s00330-011-2093-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2010] [Accepted: 01/08/2011] [Indexed: 11/28/2022]
Affiliation(s)
- Tobias Struffert
- Department of Neuroradiology, University of Erlangen-Nuremberg, Schwabachanlage 6, 91054 Erlangen, Germany.
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de Oliveira IA, Mendes Pereira Caldas JG, Araújo Oliveira H, de Abreu Costa Brito E. Development of a new experimental model of saccular aneurysm by intra-arterial incubation of papain in rabbits. Neuroradiology 2010; 53:875-81. [PMID: 21104075 DOI: 10.1007/s00234-010-0785-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2010] [Accepted: 10/13/2010] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Experimental saccular aneurysms can be created with surgical techniques of the arterial wall or by injecting pancreatic elastase. Papain is an enzyme with properties similar to those of elastase, and it has not been tested for this purpose. The objective of this study was to determine whether papain produces saccular aneurysms. METHODS Eleven New Zealand white rabbits (1.9-3.0 kg) were divided into two groups: group I (n = 8)-papain, and group II (n = 3)-sham. The animals underwent surgical exposure of the neck; the right common carotid artery was used as the test and the left common carotid artery as the control. On the 21st day after surgery, animals were sacrificed for removal of the arteries, measurements, and histological analysis. We determine formation of aneurysm to occur when the test artery dilated compared to the control. RESULTS There was no aneurysm formation in the sham group. The papain group showed aneurysm formation in all cases (100%). The average diameter of the aneurysms was 3.8 ± 1.4 mm and the average length was 16.7 ± 6.0 mm. The histological analysis showed a destruction of the elastic fibers in 100% of cases, mild inflammation in 62.5%, intimal fibrosis in 50%, endothelial injury in 100%, and thrombosis in 100% of cases. CONCLUSION Papain was capable of forming aneurysms with histological characteristics similar to those of elastase-induced aneurysms; however, a comparative study is necessary to determine whether the papain is superior to elastase in the production of experimental saccular aneurysms.
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Affiliation(s)
- Ivanilson Alves de Oliveira
- Experimental Medicine Laboratory, Universidade Federal de Sergipe-UFS, Rua Manoel Domingos Pereira, 378, Itabaiana, Sergipe 49500-000, Brazil.
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Kang W, Connor J, Yan X, Neely B, Carney E, Ellwanger J, Huang Y. A modified technique improved histology similarity to human intracranial aneurysm in rabbit aneurysm model. Neuroradiol J 2010; 23:616-21. [PMID: 24148684 DOI: 10.1177/197140091002300512] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2010] [Accepted: 07/30/2010] [Indexed: 11/15/2022] Open
Abstract
Persistent undigested elastic membranes and collagen in the tunic media of rabbit elastase-induced aneurysm models lowered their histology similarity to human intracranial aneurysm. Our purpose was to make good the deficiency. Ten New Zealand white rabbits were divided into three groups: six rabbit in two groups for evaluating the difference in various treatments, and four rabbits for long-term observation. We inflated and occluded the right common carotid artery (CCA) by an endovascular technique. The first group of three rabbits was only given 200u elastase in the proximal segment of right CCA; the second group was given 100u elastase and 1.5mg collagenase, then the right CCA was ligated. The first and second groups were studied by magnetic resonance angiography (MRA), sacrificed at three weeks after aneurysm creation, their histology results were obtained and compared with human aneurysm. The third group underwent the same procedure as the second group only for three months of observation with enhanced MRA. Saccular aneurysms formed in all rabbits. Degeneration of the extracellular matrix and atrophy of smooth muscular cells in tunic media were more apparent in the second group. The third group remained stable for more three months. Two modifications included inflating the right CCA with a balloon and adding collagenase incubation can promote an aneurysm model more histologically similar to human aneurysm. In addition the improved aneurysm model remains stability for a long time.
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Affiliation(s)
- W Kang
- Department of Neurosurgery, Tianjin Central Neurosurgery Hospital; Tianjin, China -
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Sherif C, Marbacher S, Erhardt S, Fandino J. Improved microsurgical creation of venous pouch arterial bifurcation aneurysms in rabbits. AJNR Am J Neuroradiol 2010; 32:165-9. [PMID: 20966054 DOI: 10.3174/ajnr.a2235] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE The choice of the experimental aneurysm model is essential for valid embolization-device evaluations. So far, the use of the rabbit venous pouch arterial bifurcation aneurysm model has been limited by demanding microsurgery, low aneurysm patency rates, and high mortality. This study aimed to facilitate microsurgery and to reduce mortality by optimized peri-/postoperative management. MATERIALS AND METHODS Aneurysms were created in 16 New Zealand white rabbits under general intravenous anesthesia. Using modified microsurgical techniques, we sutured a jugular vein pouch into a bifurcation created between both CCAs. Aggressive anticoagulation (intraoperative intravenous: 1000-IU heparin, 10-mg acetylsalicylic acid/kg; postoperative subcutaneous: 14 days, 250-IU/kg /day heparin) and prolonged postoperative anesthesia (fentanyl patches: 12.5 μg/h for 72 hours) were applied. Angiographic characteristics of created experimental aneurysms were assessed. RESULTS The reduced number of interrupted sutures and aggressive anticoagulation caused no intra-/postoperative bleeding, resulting in 0% mortality. Four weeks postoperation, angiography showed patency in 14 of 16 aneurysms (87.5%) and Ohshima type B bifurcation geometry. Mean values of parent-artery diameters (2.3 mm), aneurysm lengths (7.9 mm), and neck widths (4.1 mm) resulted in a mean 1.9 aspect ratio. CONCLUSIONS Compared with historical controls, the use of modified microsurgical techniques, aggressive anticoagulation, and anesthesia resulted in higher aneurysm patency rates and lower mortality rates in the venous pouch arterial bifurcation aneurysm model. Gross morphologic features of these aneurysms were similar to those of most human intracranial aneurysms.
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Affiliation(s)
- C Sherif
- Department of Neurosurgery, Cantonal Hospital of Aarau, Switzerland.
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Ding Y, Dai D, Kadirvel R, Lewis DA, Kallmes DF. Creation of large elastase-induced aneurysms: presurgical arterial remodeling using arteriovenous fistulas. AJNR Am J Neuroradiol 2010; 31:1935-7. [PMID: 20634302 DOI: 10.3174/ajnr.a2205] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE The size of elastase-induced aneurysms created in the usual way is relatively small. Our aim was to determine whether creation of a carotid-jugular AVF to induce remodeling of the RCCA results in larger elastase-induced aneurysms in rabbits. MATERIALS AND METHODS RCCA right-jugular AVFs were created in 6 New Zealand white rabbits (group 1), followed by elastase-induced aneurysm creation 4 weeks later. Follow-up DSA was performed to assess AVF patency and aneurysm sizes. Six other elastase-induced aneurysms created in the usual way were used as controls (group 2). The diameters of the RCCA and LCCA in group 1 and aneurysm sizes in both groups were measured from DSA images and compared by using the Student t test. RESULTS The patency of AVFs in group 1 was confirmed in all 6 (100%) cases. The mean RCCA diameter in group 1 was larger than that in the contralateral LCCA (3.6 ± 0.7 mm versus 2.0 ± 0.1 mm, range, 1.8-2.2 mm, P < .01). The mean aneurysm neck diameter, width, and height for group 1 was larger than those of group 2 (4.6 ± 0.9 mm versus 3.5 ± 0.7 mm, P < .05; 4.7 ± 1.1 mm versus 3.4 ± 0.5 mm, P < .05; 13.8 ± 3.2 mm versus 8.1 ± 1.3 mm, P < .05, respectively). Aneurysm volume for group 1 was significantly larger than that of group 2 (273 ± 172 mm³ versus 77 ± 32 mm³, P < .05). CONCLUSIONS Carotid-jugular AVFs result in RCCA remodeling that yields relatively larger elastase-induced aneurysms.
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Affiliation(s)
- Y Ding
- Department of Radiology, Mayo Clinic, Rochester, Minnesota 55905, USA
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Goericke SL, Parohl N, Albert J, Dudda M, Forsting M. Elastase-induced aneurysm in Swine: proof of feasibility in a first case. A technical note. Interv Neuroradiol 2010; 15:413-6. [PMID: 20465878 DOI: 10.1177/159101990901500406] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2009] [Accepted: 11/21/2009] [Indexed: 11/17/2022] Open
Abstract
SUMMARY This is the first description of a modified endovascular elastase-induced aneurysm model in swine. The advantage of this model is the combination of an aneurysm of true vessel continuation with arterial wall and the possibility of using large femoral access devices. Imaging revealed a successful aneurysm creation at the origin of the right CCA. High personal and financial expense and partial thrombus formation might limit the routine use and this model might be reserved for exclusive issues.
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Affiliation(s)
- S L Goericke
- Institute of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital; Essen, Germany -
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Hoh BL, Velat GJ, Wilmer EN, Hosaka K, Fisher RC, Scott EW. A novel murine elastase saccular aneurysm model for studying bone marrow progenitor-derived cell-mediated processes in aneurysm formation. Neurosurgery 2010; 66:544-50; discussion 550. [PMID: 20173550 DOI: 10.1227/01.neu.0000365616.46414.2b] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Although there are several large-species animal models for saccular aneurysms, there is a need for a simple, reproducible saccular aneurysm model in mice. OBJECTIVE To develop a murine saccular aneurysm model, which replicates key characteristics that occur in the formation of human cerebral aneurysms. METHODS Elastase is applied extravascularly to the right common carotid artery. We induced saccular aneurysm formation by our method in C57BL/6 mice (n = 30). Aneurysms and control arteries (left common carotid arteries) were harvested at 1 week, 2 weeks, and 3 weeks postinjury (n = 10 for each time point), measured, and stained for elastin content. To demonstrate BMP-derived cell recruitment to the aneurysms, bone marrow from UBC-gfp transgenic mice was transplanted into irradiated C57BL/6 recipients to create C57BL/6.gfp chimeras. Additionally, bone marrow from DsRed transgenic mice was transplanted into irradiated C57BL/6 recipients to create C57BL/6.DsRed chimeras, and bone marrow from B5/EGFP transgenic mice was transplanted into irradiated FVB recipients to create FVB.gfp chimeras. The elastase injury or sham operations were performed in the C57BL/6.gfp, C57BL/6.DsRed, and FVB.gfp chimeras. Aneurysms and sham vessels were harvested at 3 weeks and examined for BMP-derived cell recruitment. Additionally, aneurysms were stained for matrix metalloproteinase-9, which is overexpressed in human cerebral aneurysm tissue. RESULTS Aneurysms consistently demonstrated significant loss of elastin in the vessel wall and had significantly larger diameters than control vessels (591 +/- 238 microm vs 328 +/- 61 microm; P = .003 for aneurysms 3 weeks postinjury). Aneurysms from C57BL/6.gfp, FVB.gfp, and C57BL/6.DsRed chimeras consistently revealed significant BMP-derived cell recruitment in the aneurysm wall that was not seen in sham-operated vessels nor in control left common carotid arteries. Aneurysms demonstrated overexpression of matrix metalloproteinase-9. CONCLUSION We describe a novel murine elastase saccular aneurysm model that replicates the histopathology and BMP-derived cell-mediated processes that will be a valuable instrument for studying the cell-mediated processes in cerebral aneurysm formation.
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Affiliation(s)
- Brian L Hoh
- Department of Neurological Surgery, University of Florida, Gainesville, Florida 32610, USA.
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Ding Y, Dai D, Kadirvel R, Lewis DA, Kallmes DF. Five-year follow-up in elastase-induced aneurysms in rabbits. AJNR Am J Neuroradiol 2010; 31:1236-9. [PMID: 20223890 DOI: 10.3174/ajnr.a2056] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE There is no report regarding patency of elastase-induced aneurysms for more than a 2-year period. Our aim was to report aneurysm patency rates up to 5 years in the elastase-induced aneurysm model in rabbits. MATERIALS AND METHODS Twenty-five elastase-induced aneurysms were created in New Zealand white rabbits and followed for up to 5 years. Thirteen (52%) rabbits died during follow-up for reasons unrelated to the aneurysms. DSA was performed at 1 month and at 2 and 5 years in the 12 surviving subjects. Aneurysm patency and dimensions, including neck diameter and aneurysm width and height, were evaluated at each time point in relation to external sizing devices. Differences of aneurysm sizes (neck width and aneurysm width and height) among time points were compared by using the Student t test. RESULTS Eleven (92%) of the 12 aneurysms in the subjects that survived for 5 years remained fully patent throughout follow-up. A single narrow-neck aneurysm showed partial thrombosis at the 2- and 5-year time points. CONCLUSIONS Experimental elastase-induced aneurysms in rabbits demonstrate high rates of patency up to 5 years following creation. When planning for very long-term studies, investigators should plan for relatively high rates of mortality unrelated to aneurysm pathology.
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Affiliation(s)
- Y Ding
- Neuroradiology Research Laboratory, Department of Radiology, Mayo Clinic, Rochester, Minnesota 55905, USA
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Kühn AL, Roth C, Romeike B, Grunwald IQ. Treatment of elastase-induced intracranial aneurysms in New Zealand white rabbits by use of a novel neurovascular embolization stent device. Neuroradiology 2009; 56:59-65. [DOI: 10.1007/s00234-009-0605-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2009] [Accepted: 09/25/2009] [Indexed: 11/24/2022]
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Nuki Y, Tsou TL, Kurihara C, Kanematsu M, Kanematsu Y, Hashimoto T. Elastase-induced intracranial aneurysms in hypertensive mice. Hypertension 2009; 54:1337-44. [PMID: 19884566 DOI: 10.1161/hypertensionaha.109.138297] [Citation(s) in RCA: 124] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Mechanisms of formation and growth of intracranial aneurysms are poorly understood. To investigate the pathophysiology of intracranial aneurysms, an animal model of intracranial aneurysm yielding a high incidence of large aneurysm formation within a short incubation period is needed. We combined two well-known clinical factors associated with human intracranial aneurysms, hypertension and the degeneration of elastic lamina, to induce intracranial aneurysm formation in mice. Roles of matrix metalloproteinases (MMPs) in this model were investigated using doxycycline, a broad-spectrum MMP inhibitor, and MMP knockout mice. Hypertension was induced by continuous infusion of angiotensin II for 2 weeks. The disruption of elastic lamina was achieved by a single stereotaxic injection of elastase into the cerebrospinal fluid at the right basal cistern. A total of 77% of the mice that received 35 milliunits of elastase and 1000 ng/kg per minute of angiotensin II developed intracranial aneurysms in 2 weeks. There were dose-dependent effects of elastase and angiotensin II on the incidence of aneurysms. Histologically, intracranial aneurysms observed in this model closely resembled human intracranial aneurysms. Doxycycline, a broad-spectrum MMP inhibitor, reduced the incidence of aneurysm to 10%. MMP-9 knockout mice, but not MMP-2 knockout mice, had reduced the incidence of intracranial aneurysms. In summary, a stereotaxic injection of elastase into the basal cistern in hypertensive mice resulted in intracranial aneurysms that closely resembled human intracranial aneurysms. The intracranial aneurysm formation in this model appeared to depend on MMP activation.
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Affiliation(s)
- Yoshitsugu Nuki
- Department of Anesthesia and Perioperative Care, University of California, San Francisco, 1001 Potrero Ave, No. 3C-38, San Francisco, CA 94110, USA
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Bouzeghrane F, Naggara O, Kallmes DF, Berenstein A, Raymond J. In vivo experimental intracranial aneurysm models: a systematic review. AJNR Am J Neuroradiol 2009; 31:418-23. [PMID: 19875466 DOI: 10.3174/ajnr.a1853] [Citation(s) in RCA: 79] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Animal models are necessary to develop and test innovations in aneurysm therapy before clinical introduction. This review aims at identifying the most likely candidates for standardizing preclinical testing of aneurysm devices. We systematically searched electronic databases for publications on animal aneurysm models from 1961-2008 to assess the methodologic quality of the studies and collect data on the patency and angiographic and pathologic outcomes of treatments. There has been a steady increase in the annual number of publications with time. Species that were most frequently used were dogs, rabbits, and rodents, followed by swine. Most publications are single-laboratory studies with variables and poorly validated outcome measures, a small number of subjects, and limited standardization of techniques. The most appropriate models to test for recurrences after endovascular occlusion were the surgical bifurcation model in dogs, and the elastase-induced aneurysm model in rabbits. A standardized multicenter study is needed to improve the preclinical evaluation of endovascular devices in aneurysm therapy.
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Affiliation(s)
- F Bouzeghrane
- Research Center, Centre Hospitalier de l'Université de Montréal, Notre-Dame Hospital, Montreal, Québec, Canada
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DeLeo MJ, Gounis MJ, Hong B, Ford JC, Wakhloo AK, Bogdanov AA. Carotid artery brain aneurysm model: in vivo molecular enzyme-specific MR imaging of active inflammation in a pilot study. Radiology 2009; 252:696-703. [PMID: 19546428 DOI: 10.1148/radiol.2523081426] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
PURPOSE To demonstrate the feasibility of using a myeloperoxidase (MPO)-specific paramagnetic magnetic resonance (MR) contrast agent to identify active inflammation in an animal model of common carotid artery (CCA) aneurysm. MATERIALS AND METHODS All animal experiments were approved by the institutional animal care and use committee. Elastase-induced saccular aneurysms were created at the root of the right CCA in 16 New Zealand white rabbits. Intramural and perivascular injection of Escherichia coli lipopolysaccharide (LPS) was performed with an endovascular approach to induce aneurysm inflammation. After intraarterial injection of an MPO-specific (di-5-hydroxytryptamide of gadopentetate dimeglumine, 0.1 mmol per kilogram of bodyweight) or a non-MPO-specific (di-tyrosine of gadopentetate dimeglumine, 0.1 mmol/kg) contrast agent, animals underwent 3-T MR imaging. Intramural presence of MPO in aneurysms in which LPS had been injected was confirmed at immunohistologic analysis. Active MPO activity was verified by measuring the spectrophotometric oxidation of guaiacol. RESULTS Endovascular injection of LPS resulted in inflammatory cell infiltration into the aneurysm wall, and there was a difference in active MPO expression between aneurysms in which LPS had been injected and control aneurysms (20.3 ng of MPO per milligram of tissue vs 0.12 ng of MPO per milligram of tissue, respectively; P < .002). MR imaging with di-5-hydroxytryptamide of gadopentetate dimeglumine revealed a difference in enhancement ratio between inflamed aneurysms in which LPS had been injected and control aneurysms (1.55 +/- 0.05 vs 1.16 +/- 0.10, respectively; P < .02). In inflamed aneurysms, di-5-hydroxytryptamide of gadopentetate dimeglumine exhibited delayed washout kinetics compared with the kinetics of di-tyrosine of gadopentetate dimeglumine. This finding enabled the verification of MPO specificity. CONCLUSION The findings of this pilot study established the feasibility of an animal model of saccular aneurysm inflammation that can be seen with clinical-field-strength MR imaging and use of the enzyme-sensitive MR contrast agent di-5-hydroxytryptamide of gadopentetate dimeglumine, which is a paramagnetic MPO substrate that specifically enhances MR signal.
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Affiliation(s)
- Michael J DeLeo
- Department of Radiology, University of Massachusetts Medical School, 55 Lake Ave North, Worcester, MA 01655, USA
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Trager AL, Sadasivan C, Seong J, Lieber BB. Correlation between angiographic and particle image velocimetry quantifications of flow diverters in an in vitro model of elastase-induced rabbit aneurysms. J Biomech Eng 2009; 131:034506. [PMID: 19154077 DOI: 10.1115/1.3049528] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The rupture of a cerebral aneurysm can result in a hemorrhagic stroke. A flow diverter, which is a porous tubular mesh, can be placed across the neck of a cerebral aneurysm to induce the cessation of flow and initiate the formation of an intra-aneurysmal thrombus. By finding a correlation between particle image velocimetry (PIV) and digital subtraction angiography, a better assessment of how well an aneurysm is excluded from the parent artery can be made in the clinical setting. A model of a rabbit elastase-induced aneurysm was connected to a mock circulation loop. The model was then placed under angiography. Recorded angiograms were analyzed so that a contrast concentration-time curve based on the average grayscale intensity inside the aneurysm could be determined. That curve was then fitted to a mathematical model that quantifies the influence of convection and diffusion on contrast transport. Optimized parameters were correlated with the intraneurysmal mean kinetic energy measured by PIV in the same aneurysm model. A strong correlation was observed between the convection and diffusion time constants and the mean kinetic energy inside the aneurysm. Analyzing the flow of angiographic contrast into and out of the aneurysm after implantation of a flow diverter allows for prediction of the efficacy of the device in excluding the aneurysm. Correlating hydrodynamic measures obtained by angiography to those obtained by detailed techniques such as PIV increases confidence in such predictions.
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Affiliation(s)
- Asher L Trager
- Department of Biomedical Engineering, University of Miami, 1251 Memorial Drive, Coral Gables, FL 33146, USA.
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Kuraishi K, Iwata H, Nakano S, Kubota S, Tonami H, Toda M, Toma N, Matsushima S, Hamada K, Ogawa S, Taki W. Development of nanofiber-covered stents using electrospinning:In vitroand acute phasein vivoexperiments. J Biomed Mater Res B Appl Biomater 2009; 88:230-9. [DOI: 10.1002/jbm.b.31173] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Hemodynamics and cerebrovascular disease. ACTA ACUST UNITED AC 2008; 70:447-53. [DOI: 10.1016/j.surneu.2008.07.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2008] [Accepted: 07/16/2008] [Indexed: 11/20/2022]
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