Abstract
High-volume intra- and extra cranial artery bypass surgery has been widely used, but it remains a difficult technique for most of surgeons. The objective of this study is to explore a training mode and platform. Six healthy dogs were divided into three groups at random. Twelve high-volume common carotid-external carotid bypasses were operated on both sides of six dogs (n=12). Digital subtraction angiography (DSA) and color Doppler sonography were taken to measure the hemodynamic parameters of grafts one week (n=4), four weeks (n=4) and 24 weeks (n=4) after the operations. The grafts were taken out for histopathological examination 24 weeks after the operations. The high-volume common carotid-external carotid bypass model (n=12) was successfully established in six dogs under microscope. Post-operative DSA in Week 1 (n=4), Week 4 (n=4) and Week 24 (n=4) showed bilateral external carotid blood flow was supplied by contralateral common carotid grafts. Both ends and the whole grafts were patent. Color Doppler sonography showed clearly that the blood flow volume of grafts was higher than 90 ml/min. Histopathological examination taken 24 weeks after the operations showed intimal hyperplasia of grafts. Dog model of high-volume common carotid-external carotid bypass has the advantages of similar material, high volume, similar blood pressure, feasible operation and high patent rate compared to the traditional microsurgery model, making it a better simulation training platform which is closer to the real surgical procedure for surgeons willing to master the technique of high-volume bypass operation. Key words: Dog, animal model, bypass, high-volume, vascular anastomosis.
Highlights
The vascular anastomosis was completed with interrupted suture for No.1 and No.2 dogs or continuous suture for No 3 to 6 dogs
All dogs were of similar mental state, physical activities, foraging and feeding state with before except for one dog that had choking induced by nervuslaryn geuscranialis injury during the surgery
The technique of employing radial artery as a coronary artery bypass graft was firstly induced in intracranial bypass by (Ausman et al, 1978).These years, GiulianoMaselli and his colleagues have reported the possibility of endovascular stent in the event of a narrowing of the bypass (Maselli et al, 2011)
Summary
Extra cranial–intracranial bypass has been playing a more and more important role in the treating of diseases including ischemic cerebrovascular diseases, complicated aneurysms and skull base tumors (Eliason et al, 2002; Evans et al, 2004; Deshmukh et al., 2005; Mohit et al, 2007; Sekhar et al, 2008; Patel et al., 2010; Xu et al, 2011; Ramanathan et al, 2012; Kalani et al, 2013; Lougheed et al, 1971). License 4.0 International License popularization of high-volume intra- and extra cranial artery bypass and to provide a simulation training platform for concerning neurosurgeons, vascular surgeons and skull base surgeons
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