gms | German Medical Science

Objective: The aim of this study was to develop an experimental pig model for the induction of a true cerebral sinus thrombosis with human blood clot which impairs the superior sagittal, the transverse sinus and the bridging veins. The model should be appropriate for further MR investigations, and artefacts should be minimized.

Methods: A combined surgical and interventional approach was chosen in six pigs. After skin incision the skull bone was removed in an area of 3 cm². The superior sagittal sinus was punctured and a coated guide wire was advanced towards the confluens sinuum. Using this guide wire a 4F introducer sheath was inserted. The sinus lumen and control of the access was visualized by direct contrast injection through the sheath using digital subtraction phlebography. A 4mm balloon mounted on a 2 F catheter was inserted through the sheath and pushed towards the torcular herophili. After inflation of the balloon, 4ml of a human blood-thromboplastine mixture were injected. Digital subtraction phlebography and MR imaging were done before and after thrombus induction.

Results: Induction of cerebral sinus thrombosis was successfully achieved in all 6 animals. In every case the thrombosis involved nearly the whole superior sagittal and transverse sinus. Blood flow along the sinus walls and surrounding the thrombus was seen as a typical sign for a fresh thrombosis. In 2 animals, subdural hemmorrhage occured presumingly due to sinus perforation. MR imaging of thrombosed sinus could be easily performed with only slight impairment of image quality in the region of the surgical approach.

Conclusions: We have developed a reliable new pig model for induction of human blood clot sinus thrombosis. MR measurements of clots can be done without significant artefacts.