Improved microsurgical creation of venous pouch arterial bifurcation aneurysms in rabbits.
OBJECTIVE
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.


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.
Department of Neurosurgery, Cantonal Hospital of Aarau, Switzerland. camillo.sherif@ksa.ch
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Sherif
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Marbacher
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Erhardt
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Fandino
D000818:Animals; D002533:Cerebral Angiography; D002536:Cerebral Arteries / Q000601:surgery*; D004195:Disease Models, Animal; D006801:Humans; D002532:Intracranial Aneurysm / Q000000981:diagnostic imaging / Q000601:surgery*; D008866:Microsurgery / Q000379:methods*; D019635:Neurosurgical Procedures / Q000379:methods*; D011817:Rabbits; D014656:Vascular Surgical Procedures / Q000379:methods*