Chicken eggs in the early phase of breeding are between in vitro and in vivo systems and provide a vascular test environment not only to study angiogenesis but also to study tumorigenesis. After the chick chorioallantoic membrane (CAM) has developed, its blood vessel network can be easily accessed, manipulated and observed and therefore provides an optimal setting for angiogenesis assays. Since the lymphoid system is not fully developed until late stages of incubation, the chick embryo serves as a naturally immunodeficient host capable of sustaining grafted tissues and cells without species-specific restrictions. In addition to nurturing developing allo-and xenografts, the CAM blood vessel network provides a uniquely supportive environment for tumor cell intravasation, dissemination, and vascular arrest and a repository where arrested cells extravasate to form micro metastatic foci.For experimental purposes, in most of the recent studies the CAM was exposed by cutting a window through the egg shell and experiments were carried out in ovo, resulting in significant limitations in the accessibility of the CAM and possibilities for observation and photo documentation of effects. When shell-less cultures of the chick embryo were used 1-4 , no experimental details were provided and, if published at all, the survival rates of these cultures were low. We refined the method of ex ovo culture of chick embryos significantly by introducing a rationally controlled extrusion of the egg content. These ex ovo cultures enhance the accessibility of the CAM and chick embryo, enabling easy in vivo documentation of effects and facilitating experimental manipulation of the embryo. This allows the successful application to a large number of scientific questions: (1) As an improved angiogenesis assay 5,6 , (2) an experimental set up for facilitated injections in the vitreous of the chick embryo eye 7-9 , (3) as a test environment for dissemination and intravasation of dispersed tumor cells from established cell lines inoculated on the CAM 10-12 , (4) as an improved sustaining system for successful transplantation and culture of limb buds of chicken and mice 13 as well as (5) for grafting, propagation, and re-grafting of solid primary tumor tissue obtained from biopsies on the surface of the CAM 14 .In this video article we describe the establishment of a refined chick ex ovo culture and CAM assay with survival rates over 50%. Besides we provide a step by step demonstration of the successful application of the ex ovo culture for a large number of scientific applications.Daniel S. Dohle, Susanne D. Pasa, and Sebastian Gustmann contributed equally to this study. ProtocolAll equipment and reagents have to be purchased sterile or needs to be heat or steam sterilized or sterilized with 70% ETOH.The authors state that experiments on animals were performed in accordance with the European Communities Council Directive (86/609/EEC), following the Guidelines of the NIH regarding the care and use of animals for experimental procedures and ...

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The E-vita Open hybrid stent graft renders durable long-term performance without any proximal endoleakage or graft failure over time and represents the ideal landing or docking zone for either thoracic endovascular thoracic repair or thoraco-abdominal surgery, if required. No reinterventions were necessary down to the end of the stent graft, proving that the disease is overcome along the hybrid graft down to mid-thoracic level.