title: Haemorrhagic tracheal necrosis as a lethal complication of an aneurysm model in rabbits via endoluminal incubation with elastase.
abstract: BACKGROUND
  We describe a lethal complication of an aneurysm model in rabbits for saccular aneurysmal creation via endoluminal incubation with elastase.
  
  
  METHODS
  In 24 anaesthetized female New Zealand White rabbits, the right common carotid artery (CCA) was ligated distally to the arteriotomy. A 4F sheath was then placed retrograde into the CCA, and its origin was occluded endoluminally using a 2F Fogarty balloon. Elastase was incubated above the balloon in the separated vessel lumen for the duration of 20 minutes. Two weeks later, digital subtraction angiography was performed for aneurysm control. Two animals were then sacrificed and the aneurysm studied on histology. All animals that died within the experiment were examined post-mortem.
  
  
  RESULTS
  Following this protocol, an aneurysm with a mean size of 7.6 x 3.2 mm could be created in 11 out of 24 animals. 9 out of 13 animals with lethal outcome died from haemorrhagic necrosis of the trachea with subsequent pulmonary complications. DSA releaved an arterial branch originating from the proximal CCA in a near 90 degree-angle aiming at the trachea.
  
  
  CONCLUSIONS
  The endoluminal incubation with elastase is suitable for aneurysm creation of reproducible size that are suited to test new endovascular devices such as stents and new coils. One should always be aware of an arterial branch of the CCA supplying the trachea. In case of elastase instillation into this branch, lethal haemorrhagic necrosis of the trachea occurs. Bearing this complication in mind, we have experienced a minimal loss of animals in subsequent studies.
authors.affiliation: Department of Neurosurgery, Aachen University, Pauwelsstrasse 30, 52057 Aachen, Germany. ruth.thiex@post.rwth-aachen.de
authors.forename: R
authors.initials: R
authors.lastname: Thiex
authors.forename: F J
authors.initials: FJ
authors.lastname: Hans
authors.forename: T
authors.initials: T
authors.lastname: Krings
authors.forename: W
authors.initials: W
authors.lastname: Möller-Hartmann
authors.forename: A
authors.initials: A
authors.lastname: Brunn
authors.forename: K
authors.initials: K
authors.lastname: Scherer
authors.forename: J M
authors.initials: JM
authors.lastname: Gilsbach
authors.forename: A
authors.initials: A
authors.lastname: Thron
mesh_terms: D000818:Animals; D021721:Balloon Occlusion / Q000009:adverse effects*; D017536:Carotid Artery, Common / Q000000981:diagnostic imaging / Q000601:surgery; D004195:Disease Models, Animal; D005260:Female; D006470:Hemorrhage / Q000209:etiology* / Q000473:pathology; D007322:Instillation, Drug; D002532:Intracranial Aneurysm; D009336:Necrosis; D010196:Pancreatic Elastase / Q000008:administration & dosage / Q000009:adverse effects*; D011817:Rabbits; D011859:Radiography; D014133:Tracheal Diseases / Q000209:etiology* / Q000473:pathology
chemical_list: D010196:Pancreatic Elastase