Domuzlarda deneysel karotis bileşke anevrizma modeli ve literatür araştırması

Amaç: Deneysel anevrizma modeli intrakranial anevrizmaların tedavisini değerlendirmek için üç ayrı nedenle kullanılmıştır. Bunlar; deneysel anevrizma oluşturulurken kazanılan pratik ve tecrübeler, karşılaştırılmalı çalışmaların ve yeni prosedürlerin yapılabilmesi ve yeni tedavi yöntemlerinin geliştirilmesidir. Bu çalışmada domuzlarda deneysel karotis bileşke anevrizması oluşturulmuş ve bu konudaki literatür çalışmalarının sunulması amaçlanmıştır. Gereç ve Yöntem: Domuzlar üzerinde boyun bölgesinde karotis arter ve bileşkedeki dalları geçici anevrizma klipleri ile kapatılıp oval arter kesisi yapıldıktan sonra venöz damar grefti ile anastomoz yapılıp anevrizma oluşturuldu. Sonuçlar: Karotis arter bileşkesinde 10 adet anevrizma oluşturuldu. Anevrizmaların büyüklüğü en az 4 mm olup, boyun genişliği en az 2 mm ölçüldü. Oluşturulan anevrizmaların sadece bir tanesi tromboze oldu. Tartışma: Bu çalışmada deneysel arteriel bileşke anevrizması oluşturulurken bu modelin ve ayrıntılı literatür araştırmamızın endovasküler tekniklere ve anevrizma hemodinamiği için yapılan yeni çalışmalara ışık tutacağına ümit ediyoruz

Anahtar Kelimeler:

Deneysel sakküler anevrizma, anjiografi, hayvan modeli

Experimental carotid bifurcation aneurysm model in the pig and review of the literature

Objective: Experimentally constructed aneurysms have been used in three ways in the evaluation of therapeutic methods for intracranial aneurysms: they may be used simply for the acquisition of skill through repeated practice of certain therapeutic procedures; in comparative studies of new and/or established procedures, and in the investigation, development, and refinement of new therapies. In this article a carotid artery bifurcation saccular aneurysm model is described in the pig and also we review the experimental applications of the aneurysms in the laboratory animals. Methods: The cervical carotid and both bifurcation branches are occluded with temporary aneurysm clips for performance of an elliptical arteriotomy and anastomosis of the vein graft in the suscrofa pigs. Results: 10 aneurysms were created at the carotid bifurcation of the pig. The lower limit on the size of the aneurysm in our study was 4 mm the lower limit of the size of the arteriotomy orifice was 2 mm. Only one aneurysm had thrombosed. Conclusion: The surgical steps in the construction of this model are detailed and such a model is useful in studying aneurysm hemodynamics with various therapeutic modalities, and evaluating interventional techniques for the treatment of aneurysm

Keywords:

Experimental saccular aneurysm, angiography, animal model,

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Yong-Zhong G, Van Alphen HAM. Pathogenesis and histopatology of saccular aneurysms: review of the literature. Neurol Res 1990;12: 249-55.
Black SPW, German WJ. Observations on the relationship between the volume and the size of the orifice of experimental aneurysms. J Neurosurg 1960;17: 984-90.
Black SPW. Experimental saccular aneurysm by an arterio-venous fistula method. Mo Med 1963;60: 340-3.
German WJ, Black SPW. Experimental production of Carotid Aneurysms. New Engl J Med 1954;250: 104-6.
Guglielmi G, Ji C, Massoud TF, et al. Experimental saccular aneurysms. II. A New model in swine. Neuroradiology 1994;36: 547- 50.
Kirse DJ, Flock S, Teo C, et al. Construction of a vein- pouch aneurysm at a surgically created carotid bifurcation in the rat. Microsurgery 1996;17 (12): 681-9.
Massoud TF, Guglielmi G, Ji C et al. Experiemental Saccular Aneurysms. Review of surgically constructed models and their laboratory applications. Neuroradiology 1994;36: 537-46.
Miskolczi L, Guterman LR, Flaherty JD, et al. Saccular aneurysm induction by elastase digestion of the arterial wall: a new animal model. Neurosurgery 1998;43:595-600.
Özdamar N, Çelebi G. Pressure Distribution on the wall of experimental aneurysms. Acta Neurochirurgica 1978;45:27-34.
Spetzger U, Reul J, Weis J, et al. Endovascular coil embolization of microsurgically produced experimental bifurcation aneurysm in rabbits. Surg Neurology 1998;49: 491-4.
Stehbens WE. Experimental production of aneurysms by microvascular surgery in rabbits.Vascular Surg 1973;7: 165-75.
Strother CM, Graves VB, Rappe A. Aneurysm hemodynamics: an experimental study. AJNR 1992;13: 1089-95.
Ujiie H, Tachibana H, Hiramatsu O, et al. Effects of size and shape (aspect ratio) on the hemodynamics of saccular aneurysms: A possible index for surgical treatment of intracranial aneurysms. Neurosurgery 1999;45: 119-30.
Kerber CW, Buschman RW. Experimental carotid aneurysms: I. Simple surgical production and radiographic evaluation. Invest Radiol 1977;12: 154-7.
Mawad ME, Mawad JK, Goodman JC, et al. Long term endothelial changes in canine aneurysms embolized with GDC coils. Proc 30 th Annual Meeting American Society of Neuroradiology, 1992; p 86.
O’Reilly GV, Utsunomiya R, Rumbaugh CL, et al. Experimental arterial aneurysms: modification of the production technique. J Microsurg 1981;2: 219-23.
Sekhar LN, Sclabassi RJ, Sun M, et al. Intraaneurysmal pressure measurments in experimental saccular aneurysms in dogs. Stroke 1988;19: 352-6.
Tolstedt GE, Bell JW. Production of experimental aneurysms in the canine aorta. Anigiology 1963;14: 459-64.
Young PH, Yaşargil MG. Experimental carotid artery aneurysms in rats: a new model for microsurgical practice. J Microsurg 1982;3: 135-146.
Heilman CB, Kwan ESK, Wu JK. Aneurysm recurrence following endovascular balloon occlusion. J Neurosurg 1992;77: 260-4.
Yonekawa Y, Yaşargil MG, Handa H. Practice of microvascular anastomosis. Neurol Surg 1973;1: 345-51.
Yapor W, Jafar J, Crowell RM. One stage construction of giant experimental aneurysms in dogs. Surg Neurol 1991; 36: 426-30.
Forrest MD, O’Reilly GV. Production of experimental aneurysms at a created arterial bifurcation. AJNR 1989;10:400-2.
Roach MR. Blood flow and thrombosis (particularly in aneurysms). Thromb et Diath Hem (Suppl) 1974;59: 123-38.
Roach MR. A model study of why some intracranial aneurysms thrombose but others rupture. Stroke 1978; 9: 583-7.
Nishikawa M, Smith RD, Yonekawa Y. Experimental intracranial aneurysms. Surg Neurol 1977;7: 241-44.
Geremia GK, Hoile RD, Haklin MF, et al. Balloon embolization of experimentally created aneurysms: an animal training model. AJNR 1990;11: 659-62.
Yong- Zhong G, van Alphen HAM, Kamphorst W. Observations on experimental saccular aneurysms in the rat after 2 and 3 months. Neurol Res 1990;12: 260-3.
Sadasivan B, Ma S, Dujovny M, et al. Use of experimental aneurysms to evaluate wrapping materials. Surg Neurol 1990; 34: 3-7.
Zanetti PH, Sherman FE. Experimental evaluation of a tissue adhesive as an agent for the treatment of aneurysms and arteriovenous anomalies. J Neurosurg 1972; 36: 72-9