New Large Animal Model for Aortic Aneurysms in the Viscerorenal Segment.


Journal

The Journal of surgical research
ISSN: 1095-8673
Titre abrégé: J Surg Res
Pays: United States
ID NLM: 0376340

Informations de publication

Date de publication:
08 2019
Historique:
received: 08 11 2018
revised: 23 01 2019
accepted: 25 02 2019
pubmed: 2 4 2019
medline: 15 2 2020
entrez: 2 4 2019
Statut: ppublish

Résumé

Aortic aneurysms in the viscerorenal-segment are nowadays treatable by endovascular means. Previously, new endograft techniques were only tested in healthy animals. We aimed to establish a new large animal model for testing complex endovascular stent techniques preclinically. In sheep, four juxtarenal and two type IV thoracoabdominal aortic aneurysms were surgically created via a retroperitoneal approach. Two pieces out of a 10 × 15-cm bovine pericardial patch were sewn with the healthy aorta longitudinally. The viscerorenal segment was clamped, and the aorta was incised longitudinally. Then, the patches were longitudinally sewn together. In the meantime, antegrade flow through the native part of the aorta was already established by tangential clamping. Computed tomography angiography was performed after 4, 8, and 52 wk. Technical success was 100%. The median surgical procedure time was 3 h, the median blood loss was 210 mL, and the viscerorenal-segment clamping time was 2-4 min. The animals started drinking 1 h after arousal from anesthesia. One animal died after 1 wk because of delayed bleeding and another died after 1 y because of aneurysm rupture by a secondary bacterial infection. Four animals survived. The proximal landing zone diameter and the clock position of the vessel were stable over 52 wk. Surgical creation of an aortic aneurysm in the viscerorenal-segment in sheep was successful, without an ischemia/reperfusion injury. This animal model offers a new platform for evaluating innovative endovascular therapy options in vivo.

Sections du résumé

BACKGROUND
Aortic aneurysms in the viscerorenal-segment are nowadays treatable by endovascular means. Previously, new endograft techniques were only tested in healthy animals. We aimed to establish a new large animal model for testing complex endovascular stent techniques preclinically.
METHODS
In sheep, four juxtarenal and two type IV thoracoabdominal aortic aneurysms were surgically created via a retroperitoneal approach. Two pieces out of a 10 × 15-cm bovine pericardial patch were sewn with the healthy aorta longitudinally. The viscerorenal segment was clamped, and the aorta was incised longitudinally. Then, the patches were longitudinally sewn together. In the meantime, antegrade flow through the native part of the aorta was already established by tangential clamping. Computed tomography angiography was performed after 4, 8, and 52 wk.
RESULTS
Technical success was 100%. The median surgical procedure time was 3 h, the median blood loss was 210 mL, and the viscerorenal-segment clamping time was 2-4 min. The animals started drinking 1 h after arousal from anesthesia. One animal died after 1 wk because of delayed bleeding and another died after 1 y because of aneurysm rupture by a secondary bacterial infection. Four animals survived. The proximal landing zone diameter and the clock position of the vessel were stable over 52 wk.
CONCLUSIONS
Surgical creation of an aortic aneurysm in the viscerorenal-segment in sheep was successful, without an ischemia/reperfusion injury. This animal model offers a new platform for evaluating innovative endovascular therapy options in vivo.

Identifiants

pubmed: 30933829
pii: S0022-4804(19)30117-9
doi: 10.1016/j.jss.2019.02.054
pii:
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

156-164

Informations de copyright

Copyright © 2019 Elsevier Inc. All rights reserved.

Auteurs

Johannes Kalder (J)

European Vascular Centre Aachen-Maastricht, Department of Vascular Surgery, RWTH University Hospital Aachen, Aachen, Germany. Electronic address: JKalder@ukaachen.de.

Peter Isfort (P)

Department of Diagnostic and Interventional Radiology, RWTH University Hospital Aachen, Aachen, Germany.

Sebastian Daniel Reinartz (SD)

Department of Diagnostic and Interventional Radiology, RWTH University Hospital Aachen, Aachen, Germany.

Felix Gremse (F)

Institute for Experimental Molecular Imaging, RWTH University Hospital Aachen, Aachen, Germany.

Grace Gyamfuah Yamoah (GG)

Institute for Experimental Molecular Imaging, RWTH University Hospital Aachen, Aachen, Germany.

Valentine Gesche (V)

Institute of Textile Engineering, RWTH University Aachen, Aachen, Germany.

Drosos Kotelis (D)

European Vascular Centre Aachen-Maastricht, Department of Vascular Surgery, RWTH University Hospital Aachen, Aachen, Germany.

Rene Tolba (R)

Institute for Laboratory Animal Science and Experimental Surgery, RWTH University Aachen, Aachen, Germany.

Michael Johan Jacobs (MJ)

European Vascular Centre Aachen-Maastricht, Department of Vascular Surgery, RWTH University Hospital Aachen, Aachen, Germany; European Vascular Centre Aachen-Maastricht, Department of Vascular Surgery, University Hospital Maastricht, Maastricht, The Netherlands.

Houman Jalaie (H)

European Vascular Centre Aachen-Maastricht, Department of Vascular Surgery, RWTH University Hospital Aachen, Aachen, Germany.

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