CardioVascular and Interventional Radiology

, Volume 36, Issue 1, pp 239–244 | Cite as

Endovascular Broad-Neck Aneurysm Creation in a Porcine Model Using a Vascular Plug

  • Georg Mühlenbruch
  • Omid Nikoubashman
  • Björn Steffen
  • Mete Dadak
  • Moritz Palmowski
  • Martin Wiesmann
Technical Note

Abstract

Purpose

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.

Materials and 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.

Conclusion

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.

Keywords

Experimental IR Neurointerventions Arterial intervention Embolization Embolisation Embolotherapy Artery Brain Neurological Nervous system Aneurysms 

Notes

Conflict of interest

None.

References

  1. 1.
    Molyneux AJ, Kerr RS, Yu LM et al (2005) International Subarachnoid Aneurysm Trial (ISAT) Collaborative Group: International Subarachnoid Aneurysm Trial (ISAT) of neurosurgical clipping versus endovascular coiling in 2143 patients with ruptured intracranial aneurysms: a randomised comparison of effects on survival, dependency, seizures, rebleeding, subgroups, and aneurysm occlusion. Lancet 366:809–817PubMedCrossRefGoogle Scholar
  2. 2.
    Malisch TW, Guglielmi G, Viñuela F et al (1997) Intracranial aneurysms treated with the Guglielmi detachable coil: midterm clinical results in a consecutive series of 100 patients. J Neurosurg 87:176–183PubMedCrossRefGoogle Scholar
  3. 3.
    Gruber A, Bavinszki G, Killer M et al (1997) In vitro training model for endovascular embolization of cerebral aneurysms. Minim Invasive Neurosurg 40:121–123PubMedCrossRefGoogle Scholar
  4. 4.
    Suzuki Y, Fujitsuka M, Chaloupka JC (2005) Simulation of endovascular neurointervention using silicone models: imaging and manipulation. Neurol Med Chir (Tokyo) 45:567–572. discussion: 572–573CrossRefGoogle Scholar
  5. 5.
    Dayal R, Faries PL, Lin SC et al (2004) Computer simulation as a component of catheter-based training. J Vasc Surg 40:1112–1117PubMedCrossRefGoogle Scholar
  6. 6.
    Cloft HJ, Altes TA, Marx WF et al (1999) Endovascular creation of an in vivo bifurcation aneurysm model in rabbits. Radiology 213:223–228PubMedGoogle Scholar
  7. 7.
    Bavinzski G, al-Schameri A, Killer M et al (1998) Experimental bifurcation aneurysm: a model for in vivo evaluation of endovascular techniques. Minim Invasive Neurosurg 41:129–132PubMedCrossRefGoogle Scholar
  8. 8.
    Sherif C, Fandino J, Erhardt S et al (2011) Microsurgical venous pouch arterial-bifurcation aneurysms in the rabbit model: technical aspects. J Vis Exp 51Google Scholar
  9. 9.
    Massoud TF, Ji C, Guglielmi G et al (1994) Experimental models of bifurcation and terminal aneurysms: construction techniques in swine. Am J Neuroradiol 15:938–944PubMedGoogle Scholar
  10. 10.
    Olabe J, Olabe J, Roda J (2011) Microsurgical cerebral aneurysm training porcine model. Neurol India 59:78–81PubMedCrossRefGoogle Scholar
  11. 11.
    Ha C (2005) Amplatzer vascular plug to occlude the internal iliac arteries in patients undergoing aortoiliac aneurysm repair. J Vasc Surg 42:1058–1062PubMedCrossRefGoogle Scholar
  12. 12.
    Zeleňák K, Zeleňáková J, Deriggo J et al (2011) Flow changes after endovascular treatment of a wide-neck anterior communicating artery aneurysm by using X-configured kissing stents (cross-kissing stents) technique. Cardiovasc Intervent Radiol 34:1308–1311PubMedCrossRefGoogle Scholar
  13. 13.
    Wanke I, Forsting M (2008) Stents for intracranial wide-necked aneurysms: more than mechanical protection. Neuroradiology 50:991–998PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE) 2012

Authors and Affiliations

  • Georg Mühlenbruch
    • 1
  • Omid Nikoubashman
    • 1
  • Björn Steffen
    • 1
  • Mete Dadak
    • 1
  • Moritz Palmowski
    • 2
    • 3
  • Martin Wiesmann
    • 1
  1. 1.Department of Diagnostic and Interventional Neuroradiology, University HospitalRWTH Aachen UniversityAachenGermany
  2. 2.Department of Nuclear Medicine, University HospitalRWTH Aachen UniversityAachenGermany
  3. 3.Department of Experimental Molecular Imaging, University HospitalRWTH Aachen UniversityAachenGermany

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