Endovascular broad-neck aneurysm creation in a porcine model using a vascular plug.
OBJECTIVE
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.


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.


CONCLUSIONS
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.
Department of Diagnostic and Interventional Neuroradiology, University Hospital, RWTH Aachen University, Pauwelsstrasse 30, 52074, Aachen, Germany. gmuehlenbruch@ukaachen.de
Georg
G
Mühlenbruch
Omid
O
Nikoubashman
Björn
B
Steffen
Mete
M
Dadak
Moritz
M
Palmowski
Martin
M
Wiesmann
D000783:Aneurysm / Q000000981:diagnostic imaging* / Q000628:therapy*; D000792:Angiography / Q000379:methods; D000818:Animals; D002339:Carotid Arteries / Q000000981:diagnostic imaging; D057510:Endovascular Procedures / Q000379:methods*; D005260:Female; D005263:Femoral Artery / Q000000981:diagnostic imaging; D002532:Intracranial Aneurysm / Q000000981:diagnostic imaging / Q000628:therapy; D023421:Models, Animal; D017145:Models, Educational; D011897:Random Allocation; D012680:Sensitivity and Specificity; D055989:Septal Occluder Device; D013348:Subclavian Artery / Q000000981:diagnostic imaging*; D034421:Sus scrofa; D013552:Swine