OBJECTIVE: The microvascular anastomosis (MA) technique remains an important aspect of modern neurosurgical practice. Specialized training is essential for mastering the anastomosis of small vessels. To minimize animal use and to create a simple but realistic training model, we developed a pulsatile perfused arteries model based on turkey carotid arteries for microvascular anastomosis training. METHODS: Approximately 10-cm-long segments of turkey necks were used as a material to set up this model. The diameter of turkey carotid arteries at the neck level was found to be between 1 and 3 mm. Both carotid arteries on the neck segment were cannulated and incorporated into a closed circulation circuit consisting of silicone tubes and an infusion pump that provided continuous arterial-like flow and pulsation during the MA training. Tubing connection with both proximal and distal ends of the carotid arteries allowed circulatory patency during vessel clamping and anastomosis creation. Different fluids ranging from simple water to various colored solutions or even whole blood could be used for vascular perfusion in this experimental setup. Fluid output was maintained between 11 and 16 ml/min. Minimum pressure was set at 80 cm/H20, and maximum pressure was set at 160 cm/H20. Mean fluid flow through the arteries was 8 to 13 ml/min. End-to-end, end-to-side, and side-to-side MA may be performed on this model. RESULTS: This training model provides several advantages: the materials are easily obtainable and inexpensive, pulsatile flow through the arteries is realistic, the model is easy to manage, and there is no need for special facilities for animal care or anesthesia that are required for live animals. The diameter and structure of turkey carotid arteries are essentially identical to the human cortical vessels and distal branches of the superficial temporal artery. CONCLUSION: The pulsatile perfused carotid arteries model presents a realistic MA training model. It provides an inexpensive and simple setup for educational purposes. This technique can minimize live animal and anesthesia needs for MA training. Wide use of this model may enhance and popularize MA training and education.
OBJECTIVE: The microvascular anastomosis (MA) technique remains an important aspect of modern neurosurgical practice. Specialized training is essential for mastering the anastomosis of small vessels. To minimize animal use and to create a simple but realistic training model, we developed a pulsatile perfused arteries model based on turkey carotid arteries for microvascular anastomosis training. METHODS: Approximately 10-cm-long segments of turkey necks were used as a material to set up this model. The diameter of turkey carotid arteries at the neck level was found to be between 1 and 3 mm. Both carotid arteries on the neck segment were cannulated and incorporated into a closed circulation circuit consisting of silicone tubes and an infusion pump that provided continuous arterial-like flow and pulsation during the MA training. Tubing connection with both proximal and distal ends of the carotid arteries allowed circulatory patency during vessel clamping and anastomosis creation. Different fluids ranging from simple water to various colored solutions or even whole blood could be used for vascular perfusion in this experimental setup. Fluid output was maintained between 11 and 16 ml/min. Minimum pressure was set at 80 cm/H20, and maximum pressure was set at 160 cm/H20. Mean fluid flow through the arteries was 8 to 13 ml/min. End-to-end, end-to-side, and side-to-side MA may be performed on this model. RESULTS: This training model provides several advantages: the materials are easily obtainable and inexpensive, pulsatile flow through the arteries is realistic, the model is easy to manage, and there is no need for special facilities for animal care or anesthesia that are required for live animals. The diameter and structure of turkey carotid arteries are essentially identical to the human cortical vessels and distal branches of the superficial temporal artery. CONCLUSION: The pulsatile perfused carotid arteries model presents a realistic MA training model. It provides an inexpensive and simple setup for educational purposes. This technique can minimize live animal and anesthesia needs for MA training. Wide use of this model may enhance and popularize MA training and education.
Authors: Vadim A Byvaltsev; Serik K Akshulakov; Roman A Polkin; Sergey V Ochkal; Ivan A Stepanov; Yerbol T Makhambetov; Talgat T Kerimbayev; Michael Staren; Evgenii Belykh; Mark C Preul Journal: Minim Invasive Surg Date: 2018-03-28