The Rabbit Blood-shunt Model for the Study of Acute and Late Sequelae of Subarachnoid Hemorrhage: Technical Aspects

Abstract

Early brain injury and delayed cerebral vasospasm both contribute to unfavorable outcomes after subarachnoid hemorrhage (SAH). Reproducible and controllable animal models that simulate both conditions are presently uncommon. Therefore, new models are needed in order to mimic human pathophysiological conditions resulting from SAH. This report describes the technical nuances of a rabbit blood-shunt SAH model that enables control of intracerebral pressure (ICP). An extracorporeal shunt is placed between the arterial system and the subarachnoid space, which enables examiner-independent SAH in a closed cranium. Step-by-step procedural instructions and necessary equipment are described, as well as technical considerations to produce the model with minimal mortality and morbidity. Important details required for successful surgical creation of this robust, simple and consistent ICP-controlled SAH rabbit model are described.

The Rabbit Shunt Model of Subarachnoid Haemorrhage

“…Technical aspects and a detailed standard operating procedure of the blood shunt SAH model in the rabbit is given elsewhere [42]. In brief, the most important steps are the following: (1) SO 2 c 9 6 .…”

“…Intraventricular haemorrhage in the lateral and fourth ventricle is a rare finding. When precautions of meticulous and tight sealing of the burr holes as well as aseptic techniques in combination of antibiotic wound irrigation are followed, then it is highly unlikely that signs of cerebrospinal fluid leakage or wound infections will occur [42].…”

“…All surgical procedures are performed under sterile conditions. The most critical considerations and surgical steps required to ensure consistency and accuracy of the rabbit shunt SAH model are as follows: (1) age of the rabbit should not exceed 3-4 months in order to avoid increased mortality and prolonged DCVS [35], (2) secure ligatures of the subclavian artery are needed to prevent twisting or slippage of the catheter during careful repositioning from prone to supine position [42], (3) tight sealing of the burr holes (ICP and CBF monitoring probes) is essential to maintain a closed cranium condition [42], (4) calibration of the angiogram (using an external reference marker during DSA) must be carried out to ensure minimal bias in image post-processing [47], and (5) percutaneous puncture of the cisterna magna should be performed carefully and slowly using the external occipital protuberance (located through direct palpation) as a landmark (Fig. 5).…”

“…Step-by-step procedural instructions, necessary equipment and technical nuances to perform the rabbit blood shunt SAH model with minimal mortality and morbidity are given elsewhere [42]. There are two principle methods to simulate bleeding in the subarachnoid space close to the large cerebral vessels.…”

Systemic and CSF Interleukin-1α Expression in a Rabbit Closed Cranium Subarachnoid Hemorrhage Model: An Exploratory Study

“…Detailed protocols for surgery and angiography have been previously described elsewhere [30,31,32]. Digital subtraction angiography (DSA) was performed under general anesthesia at day 0 prior to SAH and on day 3.…”