A subscription to JoVE is required to view this content. Sign in or start your free trial.

Method Article

A Mouse Abdominal Aortic Aneurysm Model by Periadventitial Calcium Chloride and Elastase Infiltration

2.9K views

⸱

DOI:

10.3791/66674

⸱

August 2nd, 2024

 ,  ,  ,  ,  ,  , 
1Division of Vascular Surgery, Department of General Surgery, West China Hospital, Sichuan University, 2Key Laboratory of Birth Defects and Related Diseases of Women and Children of MOE, State Key Laboratory of Biotherapy, West China Second University Hospital, Sichuan University

* These authors contributed equally

In This Article

Summary

This manuscript presents a protocol for establishing a mouse abdominal aortic aneurysm model using calcium chloride and elastase, combining the advantages of previous modeling methods. This model can be utilized to investigate the pathophysiological mechanisms underlying abdominal aortic aneurysms.

Abstract

Abdominal aortic aneurysm (AAA) is a life-threatening disease associated with high mortality rates. It is characterized by the permanent dilation of the abdominal aorta with at least a 50% increase in arterial diameter. Various animal models of AAA have been introduced to mimic the pathophysiological changes and study the underlying mechanisms of AAA. Among these models, the calcium chloride (CaCl2)- and elastase-induced AAA models are commonly used in mice. However, these methods have certain limitations. Traditional intraluminal porcine pancreatic elastase (PPE) perfusion is associated with high technical difficulty and a high rupture rate, while periadventitial administration of PPE yields inconsistent results. In addition, the CaCl2-induced AAA model lacks human AAA features, such as atherothrombosis and aneurysm rupture. Therefore, the combined application of CaCl2 and PPE has been proposed as an approach to enhance success rates and induce greater diameter increases in AAA animal models. This manuscript presents a comprehensive protocol for establishing a mouse AAA model through periaortic infiltration of PPE and CaCl2 in the infrarenal segment of the abdominal aorta. By following this protocol, we can achieve an AAA formation rate of approximately 90% with technical simplicity and reproducibility. Further ultrasound and histological experiments confirm that this model effectively replicates the morphological and pathological changes observed in human AAA.

Introduction

Abdominal aortic aneurysm (AAA) is defined as a diameter increase of more than 50% or a maximum aortic diameter exceeding 3 cm in the abdominal aorta. This condition poses a significant threat to life, with around a 90% mortality rate upon aneurysm rupture1,2,3. Currently, open surgical repair and endovascular aortic repair (EVAR) are the only available interventions for AAA patients4,5,6. However, there is insufficient evidence to support the effectiveness of medical treatments in inhibiting aneurysm formation or slowing the growth rate of the abdominal aorta in patients who do not have surgical indications7. Nevertheless, non-specific treatments, including persistent surveillance of maximum aneurysm diameter, blood pressure control, antiplatelet therapy, and statins, are used to reduce the risk of sudden aneurysm rupture and potential cardiovascular and neurological events as much as possible. Despite this, the role of antiplatelet medications and statins in preventing aneurysm rupture remains controversial and requires further studies5,7,8,9,10.

A stable AAA animal model is vital for investigating the pathogenesis of AAA, and numerous methods have been introduced to establish such a model11,12,13. Currently, calcium chloride (CaCl2), elastase, angiotensin II (Ang II), xenografts, and transgenic models are used in establishing rodent AAA models11,12,13. Among these, Ang II is the most commonly used in mice, while CaCl2 and elastase are also widely used in mice and rats11,12,13,14. The Ang II-induced AAA model is the sole animal model capable of inducing atherosclerosis that closely resembles human AAA pathology, which is simple and reproducible and obviates the need for laparotomy11,12,13. However, in contrast to the models induced by CaCl2 or elastase, the site of aneurysms induced by Ang II is uncertain and frequently observed in the descending aorta or suprarenal abdominal aorta, with a heightened risk of rupture11,12,13,14. The aneurysm incidence rate of the Ang II-induced AAA model in gene-deficient mice can be as high as 100%, while only 39% of C57BL/6 mice developed aneurysms, and the time and economic cost of obtaining gene-deficient mice are high13,15.

Initially introduced by Gertz et al., CaCl2 was utilized to induce aneurysm formation in the carotid artery and later modified by Chiou et al. to establish an AAA model in mice16,17. However, despite its ability to induce elastic fiber breakdown, vessel inflammation, and extracellular matrix degradation, CaCl2 lacks several human AAA features, including atherothrombosis, intraluminal thrombus (ILT), and aneurysm rupture12,18. In addition, the formation rate and diameter increase percentage of periaortic CaCl2 application remain unstable13,19. The initial intraluminal porcine pancreatic elastase (PPE) perfusion model for inducing AAA was developed by Anidjar et al. in 1990, followed by Bhamidipati et al.'s report on periadventitial PPE infiltration in a murine model20,21. Nowadays, the majority of elastase-induced AAA animal models utilize Bhamidipati's protocol due to its feasibility and minimally invasive nature. However, it is important to note that the incidence rate and maximum diameter of AAA can vary and are generally lower than intra-aortic PPE perfusion. Moreover, aneurysms induced by periaortic application of elastase present a tendency to heal spontaneously11,12,20,21,22,23.

To address these limitations, Tanaka et al. proposed a combination approach involving intraluminal PPE perfusion and CaCl2 infiltration to establish an AAA model in rats, which yielded satisfactory results24. In addition, Zhu et al. demonstrated that the PPE + CaCl2 model offers advantages such as higher survival rates and increased aneurysm formation rates compared to both the single PPE group and the PPE + BAPN group25. This combined approach also exhibits good stability and reproducibility. Moreover, Bi et al. successfully established a rabbit AAA model via the combination of periaortic CaCl2 and elastase incubation. The average dilation ratio was 65.3% ± 8.9% on day 5, which further increased to 86.5% ± 28.7% on day 15 and significantly escalated to 203.6% ± 39.1% on day 3026. However, there is currently no existing literature reporting the induction of AAA in rodents by combining periaortic CaCl2 and elastase application.

This manuscript presents a standard protocol for establishing a murine AAA model through the combined use of periadventitial CaCl2 and elastase infiltration. The subsequent sections provide detailed surgical procedures and present representative results of the murine AAA model.

Access restricted. Please log in or start a trial to view this content.

Protocol

The animal experiment protocol complied with the National Institute of Health Guide for the Care and Use of Laboratory Animals (NIH Pub No. 86/23, 1985) and was approved by the Institutional Animal Care and Use Committee of West China Hospital, Sichuan University (Approval Number 202311300012). Eight to ten-week-old C57/B6J male mice were used for this study. The details of the reagents and equipment used are listed in the Table of Materials.

1. Preoperative preparation

  1. Obtain the animals and feed them a normal chow diet with clean water under standard conditions (temperature 24 °C, humidity 40%-50%, 12-h light-dark cycle).
  2. Cut a cotton pad into 40 mm x 4 mm strips and sterilize it along with scissors, forceps, and other surgical equipment.
  3. Place the animal into the induction chamber of the anesthesia machine and use 3%-3.5% isoflurane to quickly induce anesthesia (following institutionally approved protocols). Additionally, prescribe butorphanol (1 mg/kg, intramuscular injection) as pre-emptive analgesia medication.
    1. Remove the mouse from the chamber when it no longer responds to pain stimulation, then place a mask on the mouse and maintain the depth of anesthesia with 1%-1.5% isoflurane. Monitor respiratory rate and depth every 5-10 min.
  4. Place the mouse in a supine position on the heating pad, use adhesive tape to immobilize the limbs, and apply eye ointment to prevent dryness.
  5. Use an electric shaver or hair removal lotion to completely remove the hair in the abdominal area, then disinfect this area with povidone-iodine and ethanol-soaked cotton swabs in a circular motion at least three times.

2. Surgical procedure

  1. Place the mouse under a stereomicroscope. Use scissors to make a longitudinal incision of approximately 2-2.5 cm along the midline of the abdomen.
  2. Enter the peritoneal cavity through the linea alba (transabdominal approach), place a retractor to expose the peritoneal cavity, and pack the intestines and colon into the right half of the abdomen using normal saline-soaked gauze.
  3. Perform blunt separation of connective and adipose tissue adjacent to the infrarenal abdominal aorta and inferior vena cava (IVC) using forceps and cotton swabs. Gently dissect the abdominal aorta and expose the gap between the abdominal aorta and the overlying psoas major, as previously referenced25.
    1. Insert the sterilized cotton pad strips into that gap, being extremely careful not to damage the lumbar artery or vein. It is not necessary to isolate the abdominal aorta from the IVC.
  4. Soak the cotton ball with 0.9 M CaCl2 and place it on the adventitia of the abdominal aorta for 15 min. Use sterilized gauze to cover the abdominal cavity during the process of infiltration.
  5. Gently remove the CaCl2-soaked cotton ball and wash the infiltrated segment with 0.9% saline solution.
  6. Dilute the elastase to 2 mg/mL (8 U/mL) with ddH2O. Use an insulin syringe to apply 50 µL of diluted elastase to the infrarenal segment of the abdominal aorta and wrap the cotton pad strips to cover the abdominal aorta and IVC. Use sterilized gauze to cover the abdominal cavity during the process of infiltration. In the Sham group, use 0.9% normal saline to replace CaCl2 and PPE.
  7. 15 min later, carefully remove the gauze and cotton pad strips. Move the intestines and colon back to their original positions, cover the treated aorta with the mesentery, and moisten the intestines to prevent adhesion.
  8. Close the muscle layer and skin separately using 6-0 nonabsorbable polypropylene suture. Disinfect the surgical area with povidone-iodine and ethanol.
  9. Place the mouse on a heating pad and monitor its respiratory status until it regains consciousness. Record the operation time and the number of experimental animals. Prescribe carprofen (5 mg/kg, subcutaneously) as post-operative analgesia for at least 3 days after the surgery, according to veterinary recommendation.

3. Ultrasound examination

  1. 21 days after the surgery, conduct an ultrasound examination to evaluate the incidence rate of AAA.
  2. Anesthetize the mouse (following institutionally approved protocols) and remove the abdominal hair as previously described.
  3. Place the mouse on the heating pad of the rodent ultrasound machine. Apply ultrasonic couplant to the abdomen and measure the maximum diameter of the aneurysm and the diameter of the normal segment of the abdominal aorta.
    1. Calculate the increased percentage of the infrarenal abdominal aorta. The criterion for successful AAA formation is that the maximum diameter of the AAA has increased by 50% or more compared to the diameter of the normal segment of the infrarenal abdominal aorta.
  4. Use a napkin to wipe off the remaining ultrasonic couplant after the examination, and place the mouse on the heating pad until it has fully recovered.

4. Abdominal aorta harvest and pathological experiments

  1. Sacrifice the mouse by isoflurane overdose on the day following the ultrasound examination (following institutionally approved protocols).
  2. Open the thoracic and abdominal cavities and perform perfusion with 1x PBS through the left ventricle until the lungs and liver turn white, following the procedure described in previous literature27.
  3. Use a digital caliper to measure the external diameter of the infrarenal aorta. Harvest the infrarenal abdominal aorta under a stereomicroscope and store the vessel in 4% paraformaldehyde for 24-48 h.
  4. Remove the connective and adipose tissue surrounding the abdominal aorta. Embed the aorta in paraffin to prepare sections, cutting the sections into 3-5 µm slices as previously described18,28.
  5. Perform hematoxylin and eosin (H&E), Masson's trichrome, and Elastic-Van Gieson (EVG) staining on the deparaffinized slices using respective staining kits according to the manufacturer's instructions.
    1. Analyze the vessel structure and inflammation with H&E staining, observe extracellular matrix (ECM) degradation and collagen fibers with Masson's trichrome staining, and examine elastic fibers with EVG staining.

Access restricted. Please log in or start a trial to view this content.

Results

In this study, a total of 24 mice were included and randomly assigned: 12 in the Sham group and 12 in the PPE + CaCl2 group, respectively. All data are presented as means ± standard deviations unless otherwise stated. The average operation time was 55.67 min ± 4.08 min. There were no intra-operative deaths or aneurysm ruptures, and the survival rate within 21 days after surgery was 100%. No severe intestinal adhesions or complications related to abdominal aorta dissection were observed.

Access restricted. Please log in or start a trial to view this content.

Discussion

Research into the molecular mechanisms of AAA requires a stable animal model. Consequently, numerous AAA animal models have been established since its initial development by Economou et al. in the 1960s29. Among these models, CaCl2 is frequently employed in rodents due to its cost-effectiveness, technical simplicity, and reliable reproducibility. However, perivascular CaCl2 infiltration has been shown to be unstable in establishing AAA. Bi et al. and Freestone et al. reported...

Access restricted. Please log in or start a trial to view this content.

Disclosures

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Acknowledgements

This work was supported by the National Natural Science Foundations of China (No. 82300542, 81770471), Sichuan Science and Technology Program (No. 2022YFS0359, 2019JDRC0104) and Post-Doctor Research Project, West China Hospital, Sichuan University (No. 2023HXBH108). The funding bodies played no role in the design of the study, the collection, analysis, and interpretation of the data, and the writing of the manuscript.

Access restricted. Please log in or start a trial to view this content.

Materials

List of materials used in this article
NameCompanyCatalog NumberComments
Anesthesia MachineRWDR550
ButorphanolJiangsu Hengrui Pharmaceutical Co., Ltd220608BP1ml: 1mg
C57BL/6JGpt Male MiceGemPharmatechN000013
Calcium ChlorideSigma AldrichC4901100 g
CarprofenMCEHY-B1227100 mg
Chow DietDossy Experimental Animals Co.Ltd
Digital CaliperGreenerIP54
EthanolJinhe Pharmaceutical Co.Ltd53968275%/500 mL
EVG Staining KitSolarbioG1597
GraphPad PrismGraphpadVer 9.0.0
H&E Staining KitServicebioG1076
Insulin SyringeBD2143420
IsofluraneRWDR510-22-4100 mL
Masson Staining KitServicebioG1006
Normal SalineServicebioG4702500 mL
ParaformaldehydeBiosharpBL539A4%/500 mL
PBS, 1xServicebioG4202500 mL
Porcine Pancreatic ElastaseSigma AldrichE1250100 mg
Povidine IodineYongan Pharmaceutical Co.Ltd5%/100 mg
Prolene Polypropylene SutureEthicon LLC8709H
Rodent Ultrasound SystemFujifilmVevo 3100LT
Stereo MicroscopeOlympusSZ61
Ultrasonic CouplantKepplerKL-250250 g

References

  1. Chaikof, E. L., et al. The Society for Vascular Surgery practices guidelines on the care of patients with an abdominal aortic aneurysm. J Vasc Surg. 67 (1), 2-77 (2018).
  2. Johnston, K. W., et al. Suggested standards for reporting on arterial aneurysms. Subcommittee on reporting standards for arterial aneurysms, ad hoc committee on reporting standards, society for vascular surgery and north American chapter, international society for cardiovascular surgery. J Vasc Surg. 13 (3), 452-458 (1991).
  3. Bown, M. J., Sutton, A. J., Bell, P. R. F., Sayers, R. D. A meta-analysis of 50 years of ruptured abdominal aortic aneurysm repair. Br J Surg. 89 (6), 714-730 (2002).
  4. Erbel, R., et al. Esc guidelines on the diagnosis and treatment of aortic diseases: Document covering acute and chronic aortic diseases of the thoracic and abdominal aorta of the adult. The task force for the diagnosis and treatment of aortic diseases of the European Society of Cardiology (ESC). Eur Heart J. 35 (41), 2873-2926 (2014).
  5. Wanhainen, A., et al. Editor's choice - European Society for Vascular Surgery (ESVS) 2019 clinical practice guidelines on the management of abdominal aorto-iliac artery aneurysms. Eur J Vasc Endovasc Surg. 57 (1), 8-93 (2019).
  6. Veith, F. J., Ohki, T., Lipsitz, E. C., Suggs, W. D., Cynamon, J. Treatment of ruptured abdominal aneurysms with stent grafts: A new gold standard. Semin Vasc Surg. 16 (2), 171-175 (2003).
  7. Golledge, J., Thanigaimani, S., Powell, J. T., Tsao, P. S. Pathogenesis and management of abdominal aortic aneurysm. Eur Heart J. 44 (29), 2682-2697 (2023).
  8. Wanhainen, A., et al. Editor's choice -- European Society for Vascular Surgery (ESVS) 2024 clinical practice guidelines on the management of abdominal aorto-iliac artery aneurysms. Eur J Vasc Endovasc Surg. 67 (2), 192-331 (2024).
  9. Golledge, J., et al. Lack of an effective drug therapy for abdominal aortic aneurysm. J Intern Med. 288 (1), 6-22 (2020).
  10. Li, R., Liu, Y., Jiang, J. Research advances in drug therapy for abdominal aortic aneurysms over the past five years: An updated narrative review. Int J Cardiol. 372, 93-100 (2023).
  11. Lysgaard Poulsen, J., Stubbe, J., Lindholt, J. S. Animal models used to explore abdominal aortic aneurysms: A systematic review. Eur J Vasc Endovasc Surg. 52 (4), 487-499 (2016).
  12. Sénémaud, J., et al. Translational relevance and recent advances of animal models of abdominal aortic aneurysm. Arterioscler Thromb Vasc Biol. 37 (3), 401-410 (2017).
  13. Patelis, N., et al. Animal models in the research of abdominal aortic aneurysm development. Physiol Res. 66 (6), 899-915 (2017).
  14. Golledge, J., Krishna, S. M., Wang, Y. Mouse models for abdominal aortic aneurysm. Br J Pharmacol. 179 (5), 792-810 (2022).
  15. Deng, G. G., et al. Urokinase-type plasminogen activator plays a critical role in angiotensin II-induced abdominal aortic aneurysm. Circ Res. 92 (5), 510-517 (2003).
  16. Gertz, S. D., Kurgan, A., Eisenberg, D. Aneurysm of the rabbit common carotid artery induced by periarterial application of calcium chloride in vivo. J Clin Invest. 81 (3), 649-656 (1988).
  17. Chiou, A. C., Chiu, B., Pearce, W. H. Murine aortic aneurysm produced by periarterial application of calcium chloride. J Surg Res. 99 (2), 371-376 (2001).
  18. Zhang, S., Cai, Z., Zhang, X., Ma, T., Kong, W. A calcium phosphate-induced mouse abdominal aortic aneurysm model. J Vis Exp. (189), e64173(2022).
  19. Isenburg, J. C., Simionescu, D. T., Starcher, B. C., Vyavahare, N. R. Elastin stabilization for treatment of abdominal aortic aneurysms. Circulation. 115 (13), 1729-1737 (2007).
  20. Anidjar, S., et al. Elastase-induced experimental aneurysms in rats. Circulation. 82 (3), 973-981 (1990).
  21. Bhamidipati, C. M., et al. Development of a novel murine model of aortic aneurysms using peri-adventitial elastase. Surgery. 152 (2), 238-246 (2012).
  22. Xue, C., Zhao, G., Zhao, Y., Chen, Y. E., Zhang, J. Mouse abdominal aortic aneurysm model induced by perivascular application of elastase. J Vis Exp. (180), e63608(2022).
  23. Origuchi, N., et al. Aneurysm induced by periarterial application of elastase heals spontaneously. Int Angiol. 17 (2), 113-119 (1998).
  24. Tanaka, A., Hasegawa, T., Zhi, C., Okita, Y., Okada, K. A novel rat model of abdominal aortic aneurysm using a combination of intraluminal elastase infusion and extraluminal calcium chloride exposure. J Vasc Surg. 50 (6), 1423-1432 (2009).
  25. Zhu, J. X., et al. Establishment of a new abdominal aortic aneurysm model in rats by a retroperitoneal approach. Front Cardiovasc Med. 9, 808732(2022).
  26. Bi, Y., et al. Development of a novel rabbit model of abdominal aortic aneurysm via a combination of periaortic calcium chloride and elastase incubation. PLoS One. 8 (7), e68476(2013).
  27. Gage, G. J., Kipke, D. R., Shain, W. Whole animal perfusion fixation for rodents. J Vis Exp. (65), e3564(2012).
  28. Ishida, Y., et al. Prevention of CaCl2-induced aortic inflammation and subsequent aneurysm formation by the CCL3-CCR5 axis. Nat Commun. 11 (1), 5994(2020).
  29. Economou, S. G., Taylor, C. B., Beattie, E. J., Davis, C. B. Persistent experimental aortic aneurysms in dogs. Surgery. 47, 21-28 (1960).
  30. Freestone, T., Turner, R. J., Higman, D. J., Lever, M. J., Powell, J. T. Influence of hypercholesterolemia and adventitial inflammation on the development of aortic aneurysm in rabbits. Arterioscler Thromb Vasc Biol. 17 (1), 10-17 (1997).
  31. Carsten, C. G., et al. Elastase is not sufficient to induce experimental abdominal aortic aneurysms. J Vasc Surg. 33 (6), 1255-1262 (2001).
  32. Yue, J., Yin, L., Shen, J., Liu, Z. A modified murine abdominal aortic aneurysm rupture model using elastase perfusion and angiotensin II infusion. Ann Vasc Surg. 67, 474-481 (2020).
  33. Ailawadi, G., et al. Gender differences in experimental aortic aneurysm formation. Arterioscler Thromb Vasc Biol. 24 (11), 2116-2122 (2004).
  34. Furubayashi, K., et al. The significance of chymase in the progression of abdominal aortic aneurysms in dogs. Hypertens Res. 30 (4), 349-357 (2007).
  35. Bi, Y., et al. Performance of a modified rabbit model of abdominal aortic aneurysm induced by topical application of porcine elastase: 5-month follow-up study. Eur J Vasc Endovasc Surg. 45 (2), 145-152 (2013).
  36. Wu, X. F., Zhang, J., Paskauskas, S., Xin, S. J., Duan, Z. Q. The role of estrogen in the formation of experimental abdominal aortic aneurysm. Am J Surg. 197 (1), 49-54 (2009).

Access restricted. Please log in or start a trial to view this content.

Reprints and Permissions

Explore More Articles

Mouse AAA ModelCalcium Chloride InfiltrationPeriadventitial ApplicationInfrarenal Abdominal AortaAortic Wall ThickeningExtracellular Matrix DegradationUltrasound MeasurementHistological Examination
A Mouse Abdominal Aortic Aneurysm Model by Periadventitial Calcium Chloride and Elastase Infiltration
Contact Us
Recommend to Library

Privacy

Terms of Use

Policies

Copyright © 2026 MyJoVE Corporation. All rights reserved.