title: A Novel Murine Model of Arteriovenous Fistula Failure: The Surgical Procedure in Detail.
abstract: The arteriovenous fistula (AVF) still suffers from a high number of failures caused by insufficient remodeling and intimal hyperplasia from which the exact pathophysiology remains unknown. In order to unravel the pathophysiology a murine model of AVF-failure was developed in which the configuration of the anastomosis resembles the preferred situation in the clinical setting. A model was described in which an AVF is created by connecting the venous end of the branch of the external jugular vein to the side of the common carotid artery using interrupted sutures. At a histological level, we observed progressive stenotic intimal lesions in the venous outflow tract that is also seen in failed human AVFs. Although this procedure can be technically challenging due to the small dimensions of the animal, we were able to achieve a surgical success rate of 97% after sufficient training. The key advantage of a murine model is the availability of transgenic animals. In view of the different proposed mechanisms that are responsible for AVF failure, disabling genes that might play a role in vascular remodeling can help us to unravel the complex pathophysiology of AVF failure.
authors: Department of Nephrology, Leiden University Medical Center; Einthoven Laboratory for Experimental Vascular Medicine, Leiden University Medical Center; Department of Surgery, Leiden University Medical Center.
authors: Chun Yu
authors: CY
authors: Wong
authors: Einthoven Laboratory for Experimental Vascular Medicine, Leiden University Medical Center; Department of Surgery, Leiden University Medical Center.
authors: Margreet R
authors: MR
authors: de Vries
authors: Division of Nephrology, University of Cincinnati.
authors: Yang
authors: Y
authors: Wang
authors: Department of Surgery, Leiden University Medical Center.
authors: Joost R
authors: JR
authors: van der Vorst
authors: Department of Surgery, Leiden University Medical Center.
authors: Alexander L
authors: AL
authors: Vahrmeijer
authors: Department of Nephrology, Leiden University Medical Center; Einthoven Laboratory for Experimental Vascular Medicine, Leiden University Medical Center.
authors: Anton-Jan
authors: AJ
authors: van Zonneveld
authors: Department of Surgery, Leiden University Medical Center.
authors: Jaap F
authors: JF
authors: Hamming
authors: Division of Nephrology, University of Cincinnati.
authors: Prabir
authors: P
authors: Roy-Chaudhury
authors: Department of Nephrology, Leiden University Medical Center; Einthoven Laboratory for Experimental Vascular Medicine, Leiden University Medical Center.
authors: Ton J
authors: TJ
authors: Rabelink
authors: Einthoven Laboratory for Experimental Vascular Medicine, Leiden University Medical Center; Department of Surgery, Leiden University Medical Center.
authors: Paul H A
authors: PH
authors: Quax
authors: Department of Nephrology, Leiden University Medical Center; Einthoven Laboratory for Experimental Vascular Medicine, Leiden University Medical Center; j.i.rotmans@lumc.nl.
authors: Joris I
authors: JI
authors: Rotmans
mesh_terms: D000818:Animals; D001166:Arteriovenous Shunt, Surgical / Q000009:adverse effects*; D017536:Carotid Artery, Common / Q000473:pathology / Q000601:surgery*; D004195:Disease Models, Animal; D004730:Endothelium, Vascular / Q000473:pathology*; D006965:Hyperplasia / Q000473:pathology; D007601:Jugular Veins / Q000473:pathology / Q000601:surgery*; D051379:Mice; D006435:Renal Dialysis; D013537:Sutures; D017539:Tunica Intima / Q000473:pathology; D066253:Vascular Remodeling