Hepatic Angiography: A Procedure to Visualize Liver Tumor Vessels in a Rabbit Model

Abstract

Source: Khabbaz, R. C., et al. Development and Angiographic Use of the Rabbit VX2 Model for Liver Cancer. J. Vis. Exp. (2019).

In this video, we demonstrate a step-by-step procedure to perform hepatic angiography using a fluoroscope that enables the real-time visualization of blood vessels associated with a liver tumor in a rabbit model.

Protocol

All procedures involving animal models have been reviewed by the local institutional animal care committee and the JoVE veterinary review board.

1. Angiographic Utilization of the VX2 Liver Tumor

1. Anesthetize the rabbit using 45 mg/kg ketamine and 5 mg/kg xylazine for induction followed by intubation and maintenance with 1%-3% isoflurane as needed. When the rabbit is anesthetized, shave the surgical site using hair clippers. Clean the incision area using a triplicate wash with betadine scrub, 70% ethanol solution, and betadine solution, and drape the groin area in a sterile surgical fashion.
2. Palpate the femoral groove in the groin. When the groove has been identified, make a 2-3 cm linear incision along the groove (Figure 1).
3. Using blunt dissection, locate and isolate the femoral bundle containing the femoral vein, artery, and nerve (Figure 2).
4. Again, use blunt dissection to separate the femoral artery from the rest of the structures in the bundle and isolate the artery atop a scalpel handle (Figure 3).
5. With a 3-French introducer kit, utilize the Seldinger technique to gain access with a needle. Insert a guidewire and remove the needle to advance the 3-French sheath into the vessel (Figure 4).
   CAUTION: Avoid using excessive force in advancing the 3-French sheath, as this can result in transection of the femoral artery.
6. Under fluoroscopic guidance and using a catheter, guidewire, and iohexol contrast agent, select for the celiac trunk — typically located at the T12 level — and then advance the catheter into the left hepatic artery via the common hepatic and proper hepatic.
7. At this point, administer the agent of choice through the catheter. Once the agent is administered, remove the catheter.
8. Using 3-0 silk suture, ligate the femoral artery proximally and distally to the insertion point of the sheath. Be sure to tighten the knot proximal to the sheath as it is withdrawn to prevent bleeding.
9. Close the groin incision with 4-0 polyglactin 910 sutures on a cutting needle using a subcuticular stitch.
10. Maintain standard post-operative care and monitor animal recovery. Perform euthanasia and necropsy as needed using standard techniques.

Results

Figure 1: The femoral groove and initial incision. (A) Palpation of the hind limb allows for visualization of the femoral groove (white dotted line). (B) Initial incision in the hind limb made along the femoral groove.

Materials

List of materials used in this article

Name	Company	Catalog Number	Comments
Hair Clippers	Wahl	41870-0438
Ketamine	Henry Schein	56344
Xylazine	Akorn	59399-110-20
15-Blade	Steris	02-050-015
11-Blade	Steris	02-050-011
Scalpel Handle x 2 	Steris 	22-2381
3-0 PDS / Taper 	Ethicon 	Z305H
4 - 0 Vicryl / Cutting 	Ethicon 	J392H
3-F VSI Micro-HV Introducer Kit 	Vascular Solutions 	Custom Order (P15180391)
.018 45° angle glidewire 	Terumo 	RG*GA1818SA
Direxion bern-shape microcatheter 	Boston Scientific 	M001195230
Omnipaque 	GE 	Y510