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Boillat G, Franssen T, Wanderer S, Rey J, Casoni D, Andereggen L, Marbacher S, Gruter BE. Anatomical Variations of the Common Carotid Arteries and Neck Structures of the New Zealand White Rabbit and Their Implications for the Development of Preclinical Extracranial Aneurysm Models. Brain Sci 2023; 13:brainsci13020222. [PMID: 36831765 PMCID: PMC9954206 DOI: 10.3390/brainsci13020222] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 01/20/2023] [Accepted: 01/25/2023] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND Rabbit models involving neck arteries are of growing importance for the development of preclinical aneurysm models. An optimal understanding of the anatomy is primordial to allow the conception of models while minimizing mortality and morbidity. The aim of this study is to give reliable anatomical landmarks to allow a standardized approach to the neck vessels. METHODS We performed a necropsy on nine specimens from ongoing experimental studies. We measured the distance between the origins of the right and left common carotid artery (rCCA/lCCA) and between the rCCA and the manubrium sterni (MS). The structures at risk were described. RESULTS Female New Zealand White rabbits (NZWR) weighing 3.7 ± 0.3 kg and aged 25 ± 5 weeks were included. The rCCA origin was located 9.6 ± 1.2 mm laterally and 10.1 ± 3.3 mm caudally to the MS. In all specimens, the lCCA originated from the aortic arch, together with the brachiocephalic trunk (BCT), and 6.2 ± 3.1 mm proximally to the rCCA origin. The external and internal jugular veins, trachea and laryngeal nerve were the main structures at risk. CONCLUSIONS The data help to localize both CCAs and their origin to guide surgical approaches with the manubrium sterni as a main landmark. Special attention has to be paid to the trachea, jugular veins and laryngeal nerves.
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Affiliation(s)
- Gwendoline Boillat
- Department of Neurosurgery, Kantonsspital Aarau, 5001 Aarau, Switzerland
- Cerebrovascular Research Group, Department for BioMedical Research, University of Bern, 3010 Bern, Switzerland
- Correspondence:
| | - Tim Franssen
- Cerebrovascular Research Group, Department for BioMedical Research, University of Bern, 3010 Bern, Switzerland
| | - Stefan Wanderer
- Department of Neurosurgery, Kantonsspital Aarau, 5001 Aarau, Switzerland
- Cerebrovascular Research Group, Department for BioMedical Research, University of Bern, 3010 Bern, Switzerland
| | - Jeannine Rey
- Department of Neurosurgery, Kantonsspital Aarau, 5001 Aarau, Switzerland
- Cerebrovascular Research Group, Department for BioMedical Research, University of Bern, 3010 Bern, Switzerland
| | - Daniela Casoni
- Experimental Surgery Facility, Department for Biomedical Research, Faculty of Medicine, University of Bern, 3010 Bern, Switzerland
| | - Lukas Andereggen
- Department of Neurosurgery, Kantonsspital Aarau, 5001 Aarau, Switzerland
- Cerebrovascular Research Group, Department for BioMedical Research, University of Bern, 3010 Bern, Switzerland
| | - Serge Marbacher
- Department of Neurosurgery, Kantonsspital Aarau, 5001 Aarau, Switzerland
- Cerebrovascular Research Group, Department for BioMedical Research, University of Bern, 3010 Bern, Switzerland
| | - Basil E. Gruter
- Department of Neurosurgery, Kantonsspital Aarau, 5001 Aarau, Switzerland
- Cerebrovascular Research Group, Department for BioMedical Research, University of Bern, 3010 Bern, Switzerland
- Institute of Neuroradiology, Department of Radiology, Kantonsspital Aarau, 5001 Aarau, Switzerland
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Zhang Y, He Y, Tang C, Wu Y, Gu Y, Gu B, Chen L, Gao W, Zhou Z, Qi Y, Mao F, Sun Y, Wang W. An Improved Surgical Technique to Increase Neck Width of Elastase-Induced Aneurysm Model in Rabbits: A Prospective Study. Front Neurol 2022; 13:889140. [PMID: 35860490 PMCID: PMC9289738 DOI: 10.3389/fneur.2022.889140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Accepted: 06/02/2022] [Indexed: 11/16/2022] Open
Abstract
Background Rabbit elastase-induced aneurysms have widely been used to test various endovascular materials over the past two decades. However, wide-necked aneurysms cannot be stably constructed. Objective The purpose of the study was to increase the neck width of the elastase-induced aneurysm model in rabbits via an improved surgical technique with two temporary clips. Materials and Methods Fifty-four elastase-induced aneurysms in rabbits were successfully created. Group 1 was (n = 34) composed of cases in which two temporary aneurysm clips were placed closely medially and laterally to the origin of the right common carotid artery (RCCA), respectively. Group 2 (n = 20) included cases in which a single temporary aneurysm clip was placed crossed the origin of RCCA. Digital subtraction angiography (DSA) was performed before and immediately after elastase incubation and 3 weeks later. The diameter of the origin of RCCA before and immediately after elastase incubation and aneurysm sizes of the two groups were measured and compared. Moreover, the correlation analysis was performed between the diameter of the origin of RCCA immediately after elastase incubation and aneurysm neck width. Results The mean aneurysm neck and dome width of group 1 were both significantly larger than that of group 2 (p-value < 0.001 and p-value = 0.005, respectively). Moreover, the proportion of wide-necked aneurysms (neck width ≥4 mm) in group 1 was significantly larger than that in group 2 (p-value = 0.004) and the mean dome to neck ratio (D/N) of group 1 was smaller than that of group 2 (p-value = 0.008). Furthermore, there was a positive correlation between the diameter of the origin of RCCA immediately after elastase incubation and aneurysm neck width. Conclusion The improved surgical technique with two temporary clips, focusing on the direct contact of elastase with the origin of RCCA, could increase the neck width of elastase-induced aneurysm models in rabbits.
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Affiliation(s)
- Yang Zhang
- Institute of Diagnostic and Interventional Radiology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Yu He
- Institute of Diagnostic and Interventional Radiology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - ChaoJie Tang
- Institute of Diagnostic and Interventional Radiology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - YuFan Wu
- Institute of Diagnostic and Interventional Radiology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Yi Gu
- Institute of Diagnostic and Interventional Radiology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - BinXian Gu
- Institute of Diagnostic and Interventional Radiology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Li Chen
- Institute of Diagnostic and Interventional Radiology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - WenWei Gao
- Neurosurgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - ZhiGuo Zhou
- Joint International Research Laboratory of Resource Chemistry, Ministry of Education, Shanghai Normal University, Shanghai, China
| | - YouKe Qi
- Department of Cardiology, Shanghai Municipal Hospital of Tradition Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - FaJiang Mao
- Department of Cardiology, Shanghai Municipal Hospital of Tradition Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - YongNing Sun
- Department of Cardiology, Shanghai Municipal Hospital of Tradition Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- *Correspondence: YongNing Sun
| | - Wu Wang
- Institute of Diagnostic and Interventional Radiology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
- Wu Wang
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Ding YH, Ghozy S, Dai D, Brinjikji W, Kallmes DF, Kadirvel R. Rabbit Elastase Aneurysm Model Mimics the Recurrence Rate of Human Intracranial Aneurysms following Platinum Coil Embolization. AJNR Am J Neuroradiol 2022; 43:741-747. [PMID: 35483907 PMCID: PMC9089251 DOI: 10.3174/ajnr.a7497] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Accepted: 03/09/2022] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Intracranial aneurysms treated with coils have been associated with incomplete occlusion, particularly in large or wide-neck aneurysms. This study aimed to validate the accuracy of the rabbit elastase model in predicting aneurysm recurrence in humans treated with platinum coils. MATERIALS AND METHODS Elastase-induced saccular aneurysms were induced in rabbits and embolized with conventional platinum coils. The recurrence rates of aneurysms were retrospectively analyzed. Morphologic characteristics of aneurysms, angiographic outcomes, and histologic healing were evaluated. RESULTS A total of 28 (15.3%) of 183 aneurysms recurred. The aneurysm recurrence rate observed in this study (15.3%) is similar to those reported in multiple analyses of aneurysm recurrence rates in humans (7%-27%). The rate of recurrence was higher in aneurysms treated without balloon assistance (19/66, 28.8%) compared with those treated with balloon assistance (9/117, 7.7%). Aneurysms treated with balloon-assisted coiling had a lower recurrence rate (OR = 0.17; 95% CI, 0.05-0.47; P = .001) and higher occlusion rate (OR = 6.88; 95% CI, 2.58-20.37; P < .001) compared with those treated without balloon-assisted coiling. In this rabbit elastase-induced aneurysm model, packing density and aneurysm volume were weak predictors of aneurysm recurrence; however, the packing density was a good predictor of the occlusion rate (OR = 1.05; 95% CI, 1.02-1.10; P = .008). CONCLUSIONS The rabbit elastase aneurysm model may mimic aneurysm recurrence rates observed in humans after platinum coil embolization. Moreover, balloon assistance and high packing densities were significant predictors of aneurysm recurrence and occlusion.
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Affiliation(s)
- Y-H Ding
- From the Department of Radiology, Mayo Clinic, Rochester, Minnesota
| | - S Ghozy
- From the Department of Radiology, Mayo Clinic, Rochester, Minnesota
| | - D Dai
- From the Department of Radiology, Mayo Clinic, Rochester, Minnesota
| | - W Brinjikji
- From the Department of Radiology, Mayo Clinic, Rochester, Minnesota
| | - D F Kallmes
- From the Department of Radiology, Mayo Clinic, Rochester, Minnesota
| | - R Kadirvel
- From the Department of Radiology, Mayo Clinic, Rochester, Minnesota
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Belanger BL, Avery MB, Sen A, Eesa M, Mitha AP. Creating Clinically Relevant Aneurysm Sizes in the Rabbit Surgical Elastase Model. World Neurosurg 2021; 152:e173-e179. [PMID: 34116263 DOI: 10.1016/j.wneu.2021.05.069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Revised: 05/16/2021] [Accepted: 05/17/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND Creating aneurysm sizes in animal models that resemble human aneurysms is essential to study and test neuroendovascular devices. The commonly used rabbit surgical elastase model, however, produces saccular aneurysms that are smaller than those typically treated in humans. The goal of this study was to determine whether an increased vessel stump length and the addition of calcium chloride to the incubation solution has an effect on the resulting aneurysm size. METHODS Using a modified aneurysm creation method, 32 female New Zealand White rabbits underwent aneurysm creation procedures. Subjects were equally allocated into 4 different groups based on vessel stump length (2 cm controls vs. 3 cm) and incubation solution (elastase alone controls vs. a 1:1 mixture of elastase and calcium chloride). At 4 weeks, all animals underwent angiography to determine the resulting aneurysm size by a neurointerventionalist who was blinded to treatment group. RESULTS An increase in stump length from 2 cm to 3 cm resulted in a significant increase in the height of aneurysm (P < 0.05). Compared with control animals, the combination of a 3-cm stump length and the addition of calcium chloride to the incubation solution resulted in a significant increase in aneurysm height, width, and volume (P < 0.05). CONCLUSIONS Creating larger aneurysms is necessary for the rabbit model to be more clinically relevant. Our study demonstrated that the utilization of a 3-cm vessel stump as well as both calcium chloride and elastase in the incubation solution results in aneurysm sizes that more closely resemble the population of aneurysms treated in humans.
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Affiliation(s)
| | - Michael B Avery
- Pacific Neuroscience Institute, Providence Saint John's Health Center, Santa Monica, California, USA
| | - Arindom Sen
- Department of Chemical and Petroleum Engineering, Schulich School of Engineering, University of Calgary, Alberta, Canada
| | - Muneer Eesa
- Department of Radiology, Foothills Medical Centre, Calgary, Alberta, Canada; Department of Clinical Neurosciences, Foothills Medical Centre, Calgary, Alberta, Canada
| | - Alim P Mitha
- Hotchkiss Brain Institute, University of Calgary, Alberta, Canada; Department of Radiology, Foothills Medical Centre, Calgary, Alberta, Canada; Department of Clinical Neurosciences, Foothills Medical Centre, Calgary, Alberta, Canada.
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An atorvastatin calcium and poly(L-lactide-co-caprolactone) core-shell nanofiber-covered stent to treat aneurysms and promote reendothelialization. Acta Biomater 2020; 111:102-117. [PMID: 32442783 DOI: 10.1016/j.actbio.2020.04.044] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Revised: 04/22/2020] [Accepted: 04/24/2020] [Indexed: 01/05/2023]
Abstract
Aneurysmal subarachnoid hemorrhage is a common complication caused by an intracranial aneurysm that can lead to hemorrhagic stroke, brain damage, and death. Knowing this clinical situation, the purpose of this study was to develop a controlled-release stent covered with a core-shell nanofiber mesh, fabricated by emulsion electrospinning, for the treatment of aneurysms. By encapsulating atorvastatin calcium (AtvCa) in the inner of poly (L-lactide-co-caprolactone) (PLCL) nanofibers, the release period of AtvCa was effectively extended. The morphology and inner structure of the core-shell nanofibers were observed by scanning electron microscopy (SEM) and transmission electron microscopy (TEM), respectively. The release of AtvCa from the nanofiber system continued for more than ten weeks without a significant initial burst release. The nanofiber mesh structure degraded gradually but maintained its fiber morphology before neovascularization. The results of this study further elucidated the reendothelialization mechanism of AtvCa by analyzing the nitric oxide (NO) expression from seeded HUVECs. The in vivo studies demonstrated that the PLCL-AtvCa covered stents were capable of separating the aneurysm dome from the blood circulation, leading to the abolishment of the aneurysm. Moreover, the AtvCa controlled release promoted the in vitro proliferation of HUVECs on the nanofiber meshes, and the PLCL-AtvCa covered stents induced in vivo neovascularization. STATEMENT OF SIGNIFICANCE: Intracranial aneurysms are pathological dilatations of blood vessels that have developed an abnormally weak wall structure, thus prone to rupture. Covered stents had been demonstrated to be a method for the treatment of intracranial aneurysm. We prepared a controlled-release stent covered with a core-shell nanofiber mesh, fabricated by emulsion electrospinning, which encapsulated atorvastatin calcium in the inner portion of nanofibers. The results of this study further elucidated the reendothelialization mechanism of AtvCa by analyzing the nitric oxide (NO) expression from seeded HUVECs. The generated AtvCa-load covered stents separated the aneurysm dome from the blood circulation, and keep long-term patency of the parent artery. But also induced neovascularization, thus provide further protection against recurrence of aneurysms after nanofiber meshes degradation.
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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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7
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Wang GX, Xia C, Liu J, Cui C, Lei S, Gong MF, Wen L, Zhang D. The Relationship of Arterial Wall Enhancement Ratio on MRI with the Degree of Inflammation in a Rabbit Aneurysm Model: A Pilot Study. Acad Radiol 2019; 26:e292-e297. [PMID: 30567638 DOI: 10.1016/j.acra.2018.12.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2018] [Revised: 12/04/2018] [Accepted: 12/04/2018] [Indexed: 11/25/2022]
Abstract
RATIONALE AND OBJECTIVES To identify the relationship between enhancement ratio (ER) of aneurysm walls and degrees of inflammation. MATERIALS AND METHODS Twenty-five white rabbits were used in this study; all underwent surgery to isolate the right common carotid artery (RCCA). Twenty rabbits underwent an aneurysm creation procedure, and 5 underwent a control procedure. In the aneurysm creation procedure, there was surgical exposure of the origin of RCCA and temporary occlusion with an aneurysm clip. The distal RCCA was ligated, and the trapped segment was infused with elastase for 20 minutes, after which the clip was removed. In the control procedure, the trapped segment was infused with saline. High-resolution magnetic resonance imaging was performed at weeks 2, 3, 4, and 5 after the procedure, and wall ER was calculated. After MRI, aneurysms were harvested and stained with hematoxylin-eosin. Pearson correlation analysis and scatter plots were used to evaluate the relationship between wall ER and the degree of inflammation. The relationships between the wall ER, the number of inflammatory cells and time were analyzed by linear graphs. RESULTS Wall ER positively correlated with inflammatory cell count of the aneurysm wall (r = 0.877, p < 0.001). The relationships between wall ER, the number of inflammatory cells, and time increased and then decreased according linear graphs. CONCLUSION In this study, the aneurysm wall ER was confirmed to be associated with the degree of inflammation on the rabbit aneurysm model.
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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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Brinjikji W, Ding YH, Kallmes DF, Kadirvel R. From bench to bedside: utility of the rabbit elastase aneurysm model in preclinical studies of intracranial aneurysm treatment. J Neurointerv Surg 2016; 8:521-5. [PMID: 25904642 PMCID: PMC4932861 DOI: 10.1136/neurintsurg-2015-011704] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2015] [Accepted: 04/06/2015] [Indexed: 11/03/2022]
Abstract
Preclinical studies are important in helping practitioners and device developers improve techniques and tools for endovascular treatment of intracranial aneurysms. Thus an understanding of the major animal models used in such studies is important. The New Zealand rabbit elastase induced arterial aneurysm of the common carotid artery is one of the most commonly used models in testing the safety and efficacy of new endovascular devices. In this review we discuss: (1) the various techniques used to create the aneurysm, (2) complications of aneurysm creation, (3) natural history of the arterial aneurysm, (4) histopathologic and hemodynamic features of the aneurysm, (5) devices tested using this model, and (6) weaknesses of the model. We demonstrate how preclinical studies using this model are applied in the treatment of intracranial aneurysms in humans. The model has similar hemodynamic, morphological, and histologic characteristics to human aneurysms, and demonstrates similar healing responses to coiling as human aneurysms. Despite these strengths, however, the model does have many weaknesses, including the fact that the model does not emulate the complex inflammatory processes affecting growing and ruptured aneurysms. Furthermore, the extracranial location of the model affects its ability to be used in preclinical safety assessments of new devices. We conclude that the rabbit elastase model has characteristics that make it a simple and effective model for preclinical studies on the endovascular treatment of intracranial aneurysms, but further work is needed to develop aneurysm models that simulate the histopathologic and morphologic characteristics of growing and ruptured aneurysms.
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Affiliation(s)
| | - Yong H Ding
- Department of Radiology, Mayo Clinic, Rochester, Minnesota, USA
| | - David F Kallmes
- Department of Radiology, Mayo Clinic, Rochester, Minnesota, USA
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Huang Q, Xu J, Cheng J, Wang S, Wang K, Liu JM. Hemodynamic Changes by Flow Diverters in Rabbit Aneurysm Models. Stroke 2013; 44:1936-41. [PMID: 23640830 DOI: 10.1161/strokeaha.113.001202] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background and Purpose—
The effect of flow diverter (FD) on hemodynamic changes observed in aneurysms is inevitably affected by the actual structural configuration of deployed FD. We studied the resultant hemodynamic changes after implantation of FDs using computational fluid dynamic simulations based on micro–computed tomography reconstructions in rabbit aneurysm model.
Methods—
The FDs by micro–computed tomography images and vascular model based on rabbit-specific angiograms in 14 rabbits were reconstructed for computational fluid dynamic studies, and rabbit-specific inlet flow waveforms were used as boundary conditions. The occluded group (n=10) and unoccluded group (n=4) were divided according to the follow-up angiography. Hemodynamic parameters were separately evaluated for significance with respect to FD implantation and healing.
Results—
The normalized mean wall shear stress of the aneurysm sac and inflow volume were significantly reduced after FD deployment, and the relative residence time was significantly increased after treatment, without significant differences in mean pressure of aneurysm sac. When compared with the unoccluded group, the average relative residence time increment and percentage of inflow volume reduction in occluded group were higher. Additionally, the inlet of stream after FD deployment in the occluded group was more prevalent near the central region of the neck, whereas in the unoccluded group, it was more likely to occur near the proximal part of the neck.
Conclusions—
This study provided the real structural configurations of fully deployed FDs in vivo. We demonstrated the decrease of wall shear stress, inflow volume, increase of relative residence time, and change of inflow stream induced by FD implantation. The higher relative residence time increment, percentage of inflow volume reduction, and location of stream inlet near the central part of the neck may be closely related to healing.
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Affiliation(s)
- Qinghai Huang
- From the Department of Neurosurgery, Changhai Hospital, Second Military Medical University, Shanghai, China (Q.H., J.X., J.C., K.W., J.L.); and the Department of Mechanics and Engineering Science, Fudan University, Shanghai, China (S.W.)
| | - Jinyu Xu
- From the Department of Neurosurgery, Changhai Hospital, Second Military Medical University, Shanghai, China (Q.H., J.X., J.C., K.W., J.L.); and the Department of Mechanics and Engineering Science, Fudan University, Shanghai, China (S.W.)
| | - Jiyong Cheng
- From the Department of Neurosurgery, Changhai Hospital, Second Military Medical University, Shanghai, China (Q.H., J.X., J.C., K.W., J.L.); and the Department of Mechanics and Engineering Science, Fudan University, Shanghai, China (S.W.)
| | - Shengzhang Wang
- From the Department of Neurosurgery, Changhai Hospital, Second Military Medical University, Shanghai, China (Q.H., J.X., J.C., K.W., J.L.); and the Department of Mechanics and Engineering Science, Fudan University, Shanghai, China (S.W.)
| | - Kuizhong Wang
- From the Department of Neurosurgery, Changhai Hospital, Second Military Medical University, Shanghai, China (Q.H., J.X., J.C., K.W., J.L.); and the Department of Mechanics and Engineering Science, Fudan University, Shanghai, China (S.W.)
| | - Jian-Min Liu
- From the Department of Neurosurgery, Changhai Hospital, Second Military Medical University, Shanghai, China (Q.H., J.X., J.C., K.W., J.L.); and the Department of Mechanics and Engineering Science, Fudan University, Shanghai, China (S.W.)
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11
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Xu J, Deng B, Fang Y, Yu Y, Cheng J, Wang S, Wang K, Liu JM, Huang Q. Hemodynamic Changes Caused by Flow Diverters in Rabbit Aneurysm Models: Comparison of Virtual and Realistic FD Deployments Based on Micro-CT Reconstruction. PLoS One 2013; 8:e66072. [PMID: 23823503 PMCID: PMC3688862 DOI: 10.1371/journal.pone.0066072] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2013] [Accepted: 04/30/2013] [Indexed: 11/19/2022] Open
Abstract
Adjusting hemodynamics via flow diverter (FD) implantation is emerging as a novel method of treating cerebral aneurysms. However, most previous FD-related hemodynamic studies were based on virtual FD deployment, which may produce different hemodynamic outcomes than realistic (in vivo) FD deployment. We compared hemodynamics between virtual FD and realistic FD deployments in rabbit aneurysm models using computational fluid dynamics (CFD) simulations. FDs were implanted for aneurysms in 14 rabbits. Vascular models based on rabbit-specific angiograms were reconstructed for CFD studies. Real FD configurations were reconstructed based on micro-CT scans after sacrifice, while virtual FD configurations were constructed with SolidWorks software. Hemodynamic parameters before and after FD deployment were analyzed. According to the metal coverage (MC) of implanted FDs calculated based on micro-CT reconstruction, 14 rabbits were divided into two groups (A, MC >35%; B, MC <35%). Normalized mean wall shear stress (WSS), relative residence time (RRT), inflow velocity, and inflow volume in Group A were significantly different (P<0.05) from virtual FD deployment, but pressure was not (P>0.05). The normalized mean WSS in Group A after realistic FD implantation was significantly lower than that of Group B. All parameters in Group B exhibited no significant difference between realistic and virtual FDs. This study confirmed MC-correlated differences in hemodynamic parameters between realistic and virtual FD deployment.
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Affiliation(s)
- Jinyu Xu
- Department of Neurosurgery, Changhai Hospital, Second Military Medical University, Shanghai, China
| | - Benqiang Deng
- Department of Neurology, Changhai Hospital, Second Military Medical University, Shanghai, China
| | - Yibin Fang
- Department of Neurosurgery, Changhai Hospital, Second Military Medical University, Shanghai, China
| | - Ying Yu
- Department of Neurosurgery, Changhai Hospital, Second Military Medical University, Shanghai, China
| | - Jiyong Cheng
- Department of Neurosurgery, Changhai Hospital, Second Military Medical University, Shanghai, China
| | - Shengzhang Wang
- Department of Mechanics and Engineering Science, Fudan University, Shanghai, China
| | - Kuizhong Wang
- Department of Neurosurgery, Changhai Hospital, Second Military Medical University, Shanghai, China
| | - Jian-Min Liu
- Department of Neurosurgery, Changhai Hospital, Second Military Medical University, Shanghai, China
- * E-mail: (JL); (QH)
| | - Qinghai Huang
- Department of Neurosurgery, Changhai Hospital, Second Military Medical University, Shanghai, China
- * E-mail: (JL); (QH)
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12
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Wang Y, Ma C, Xu N, Xu K, Wang H, Yu J, Li Y, Wang K, Wang X, Luo Q. An improved elastase-based method to create a saccular aneurysm rabbit model. Br J Neurosurg 2013; 27:779-82. [PMID: 23713666 DOI: 10.3109/02688697.2013.799633] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PURPOSE To find a safe, effective, and simple method to create a rabbit aneurysm model. METHODS Twelve adult New Zealand rabbits were divided into two groups: experimental (n = 9) and control (n = 3). The origin of the right external carotid artery was occluded with a temporary aneurysm clip, after which the right external carotid artery was ligated distally. The resulting stump was infused with elastase (experimental group) or saline (control group) for 20 minutes, and the clip was removed. The animals were studied angiographically and sacrificed 3 weeks after the procedure to harvest the aneurysms for histological analysis. RESULTS All nine rabbits in the experimental group successfully developed aneurysm after 3 weeks. Aneurysms had an average height of 5.2 ± 1.1 mm and width of 3.5 ± 0.8 mm. Histological analysis showed that the tunica media of the aneurysmal wall was barely identifiable. None of the three rabbits in the control group developed an aneurysm, and instead had achieved closure of the right external carotid artery stump. CONCLUSIONS We have established an effective and a simple elastase-based method to create a rabbit aneurysm model. The procedure is easy to perform and does not require an interventional technique and or ligation of the internal carotid artery, which would otherwise reduce the blood supply to the brain.
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Affiliation(s)
- Yubo Wang
- Department of Neurosurgery, The First Hospital of Jilin University , Changchun , P. R. China
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13
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Li ZF, Fang XG, Yang PF, Huang QH, Zhao WY, Liang C, Zhao R, Liu JM. Endothelial progenitor cells contribute to neointima formation in rabbit elastase-induced aneurysm after flow diverter treatment. CNS Neurosci Ther 2013; 19:352-7. [PMID: 23528070 DOI: 10.1111/cns.12086] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2012] [Revised: 02/05/2013] [Accepted: 02/06/2013] [Indexed: 01/08/2023] Open
Abstract
AIMS Endothelial progenitor cells (EPCs) are involved in vascular repair and homeostasis after vascular injuries. In this study, we aimed to explore whether bone marrow (BM)-derived EPCs contribute to neointima formation and reendothelialization in rabbit elastase-induced aneurysm after flow diverter treatment. METHODS Elastase-induced aneurysms were created in New Zealand male rabbits. Three weeks after model creation, flow diverter was implanted to cover the induced aneurysm neck. Autologous EPCs were isolated from bone marrow, expanded ex vivo, double labeled with Hoechst 33,342 and CFSE(carboxyfluorescein diacetate succinimidyl ester), and transplanted transvenously into the rabbits. The rabbits were assigned into three groups. The first group received autologous transfusion of double-labeled EPCs from the first day after stent implantation, and the second group received transfusion from the fifteenth day. The autologous transfusion was given at a 3-day interval and continued for 2 weeks. Fluorescence-labeled cells were tracked under fluorescence microscope at the aneurysm neck and parent artery in the two groups. The third group was established as control group without EPCs transplantation. Scanning electron microscope was used to investigate the reendothelialization rate between the former two groups and the control group. RESULTS In the first group, double-positive EPCs were found in 3/5 rabbits and mainly located in the subendothelial space and around the stent struts. In the second group, double-positive EPCs were found in 2/5 rabbits and mainly located on the surface of neointima. More endothelial-like cells were observed on the neointima of aneurysm neck and stented parent artery in the groups with EPCs transplantation than control group without EPCs transplantation, but the difference on the number of these cells did not reach statistical significance. CONCLUSIONS BM-derived EPCs participate in neointima formation and reendothelialization in elastase-induced aneurysm after flow diverter treatment. The EPCs may differentiate into different cell types according to the stages of neointima formation in vivo.
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Affiliation(s)
- Zi-Fu Li
- Department of Neurosurgery, Changhai Hospital Affiliated to Second Military Medical University, Shanghai, China
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14
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Biodegradable flow-diverting device for the treatment of intracranial aneurysm: short-term results of a rabbit experiment. Neuroradiology 2013; 55:621-8. [DOI: 10.1007/s00234-013-1150-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2012] [Accepted: 01/25/2013] [Indexed: 10/27/2022]
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15
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Villano JS, Boehm CA, Carney EL, Cooper TK. Complications of elastase-induced arterial saccular aneurysm in rabbits: case reports and literature review. Comp Med 2012; 62:480-486. [PMID: 23561881 PMCID: PMC3527752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2012] [Revised: 05/25/2012] [Accepted: 06/01/2012] [Indexed: 06/02/2023]
Abstract
Endoluminal infusion and incubation of elastase with or without collagenase into the rabbit common carotid artery is an established model of arterial saccular aneurysm. The model mimics naturally occurring human cerebral aneurysms in many ways, including histologic and morphologic characteristics, hemodynamic pressures, and shear stresses. However, complications have been associated with the model. Here, we report 2 complications: 1) the first known case of iatrogenic laryngeal hemiplegia in a rabbit; and 2) histopathologically confirmed iatrogenic hippocampal and cerebellar infarcts (stroke). Finally, we present and review data from current literature on the morbidity and mortality associated with this model.
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Affiliation(s)
- Jason S Villano
- Department of Comparative Medicine, Penn State Hershey Medical Center, Hershey, PA, USA.
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Fang X, Zhao R, Wang K, Li Z, Yang P, Huang Q, Xu Y, Hong B, Liu J. Bone marrow-derived endothelial progenitor cells are involved in aneurysm repair in rabbits. J Clin Neurosci 2012; 19:1283-6. [DOI: 10.1016/j.jocn.2011.09.038] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2011] [Revised: 09/21/2011] [Accepted: 09/30/2011] [Indexed: 12/24/2022]
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Wang K, Yuan S. Elastase-induced rabbit aneurysms model complicated by thoracic aortic aneurysms. AJNR Am J Neuroradiol 2012; 33:E76-7. [PMID: 22442045 DOI: 10.3174/ajnr.a3095] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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18
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Correlation of aneurysm occlusion with actual metal coverage at neck after implantation of flow-diverting stent in rabbit models. Neuroradiology 2011; 54:607-13. [DOI: 10.1007/s00234-011-0922-7] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2011] [Accepted: 07/15/2011] [Indexed: 10/17/2022]
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