{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T01:34:02Z","timestamp":1760060042430,"version":"build-2065373602"},"reference-count":23,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2025,7,31]],"date-time":"2025-07-31T00:00:00Z","timestamp":1753920000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"EANS Research Fund"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Brain Sciences"],"abstract":"<jats:p>Introduction: Given the impact of aneurysmal subarachnoid hemorrhage (aSAH) on patients\u2019 health, preclinical research is substantial to understand its pathophysiology and improve treatment strategies, which necessitates reliable and comprehensive animal models. Traditionally, aSAH models utilize iliac or subclavian access for angiography, requiring invasive procedures that are associated with significant risks and animal burden. This pilot study explores a less invasive method of digital subtraction angiography (DSA) by using the auricular artery (AA) as an alternative access point. Our aim was to demonstrate the feasibility of this refined technique, with the intention of reducing procedural risks, providing shorter operation times with enhanced neurological recovery, and simplifying the process for both researchers and animals. Materials and Methods: In this study, six female New Zealand white rabbits (3.2\u20134.1 kg body weight) underwent experimental induction of aSAH via a subclavian-cisternal shunt. The initial steps of this procedure followed traditional techniques, consisting of subclavian access through microsurgical preparation, followed by DSA to analyze retrograde filling of the basilar artery (BA). To evaluate the alternative method, on day 3 after induction of aSAH, DSA was performed via the AA instead of the traditional subclavian or femoral access. A catheter was placed in the AA to allow retrograde filling of the BA. This approach aimed to simplify the procedure while maintaining comparable imaging quality. Results: All rabbits survived until the study endpoint. Postoperatively, two rabbits showed signs of hemisyndrome, which significantly improved by the time of follow-up. No additional morbidities were observed. Upon euthanasia and necropsy, all animals showed clear subarachnoid bleeding patterns. DSA via the AA produced strong contrasting of the BA comparable to the traditional method. Conclusions: This technical note presents an initial evaluation of AA access as a feasible and potentially advantageous method for DSA in a rabbit model of blood shunt subarachnoid hemorrhage. The method shows promise in reducing invasiveness and procedural complexity, but further studies are required to fully establish its efficacy and safety. Future research should focus on expanding the sample size, refining the anatomical understanding of the AA, and continuing to align with ethical considerations regarding animal welfare.<\/jats:p>","DOI":"10.3390\/brainsci15080826","type":"journal-article","created":{"date-parts":[[2025,8,6]],"date-time":"2025-08-06T15:09:53Z","timestamp":1754492993000},"page":"826","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Usefulness of Direct Auricular Artery Injection as Refinement of the Well-Established Rabbit Blood Shunt Subarachnoid Hemorrhage Model"],"prefix":"10.3390","volume":"15","author":[{"given":"Stefan","family":"Wanderer","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Kantonsspital Aarau, 5001 Aarau, Switzerland"},{"name":"Program for Regenerative Neuroscience, Department for BioMedical Research, University of Bern, 3008 Bern, Switzerland"},{"name":"Neurochirurgie Fathi AG, Schachen 22, 5001 Aarau, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6315-016X","authenticated-orcid":false,"given":"Michael","family":"von Gunten","sequence":"additional","affiliation":[{"name":"Institut f\u00fcr Pathologie, L\u00e4nggasse, 3063 Ittigen, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniela","family":"Casoni","sequence":"additional","affiliation":[{"name":"Experimental Surgery Facility, Formerly Under the Department for Biomedical Research, Faculty of Medicine, University of Bern, 3008 Bern, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4032-999X","authenticated-orcid":false,"given":"Stefano","family":"Di Santo","sequence":"additional","affiliation":[{"name":"Program for Regenerative Neuroscience, Department for BioMedical Research, University of Bern, 3008 Bern, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J\u00fcrgen","family":"Konczalla","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Johann Wolfgang Goethe-University, 60528 Frankfurt am Main, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ali-Reza","family":"Fathi","sequence":"additional","affiliation":[{"name":"Neurochirurgie Fathi AG, Schachen 22, 5001 Aarau, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,7,31]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1413","DOI":"10.1212\/WNL.50.5.1413","article-title":"The burden, trends, and demographics of mortality from subarachnoid hemorrhage","volume":"50","author":"Johnston","year":"1998","journal-title":"Neurology"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1159\/000346087","article-title":"European Stroke Organization guidelines for the management of intracranial aneurysms and subarachnoid haemorrhage","volume":"35","author":"Steiner","year":"2013","journal-title":"Cerebrovasc. Dis."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1711","DOI":"10.1161\/STR.0b013e3182587839","article-title":"Guidelines for the management of aneurysmal subarachnoid hemorrhage: A guideline for healthcare professionals from the American Heart Association\/american Stroke Association","volume":"43","author":"Connolly","year":"2012","journal-title":"Stroke"},{"key":"ref_4","first-page":"624","article-title":"Dynamic CT perfusion imaging in subarachnoid hemorrhage-related vasospasm","volume":"27","author":"Laslo","year":"2006","journal-title":"AJNR Am. J. Neuroradiol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"769","DOI":"10.1093\/neuros\/nyw113","article-title":"Comparison Between CTA and Digital Subtraction Angiography in the Diagnosis of Ruptured Aneurysms","volume":"80","author":"Philipp","year":"2017","journal-title":"Neurosurgrey"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"18","DOI":"10.3171\/jns.1990.73.1.0018","article-title":"The International Cooperative Study on the Timing of Aneurysm Surgery. Part 1: Overall management results","volume":"73","author":"Kassell","year":"1990","journal-title":"J. Neurosurg."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"675917","DOI":"10.3389\/fneur.2021.675917","article-title":"Pipeline Embolization Device for the Treatment of Ruptured Intracerebral Aneurysms: A Multicenter Retrospective Study","volume":"12","author":"Zhong","year":"2021","journal-title":"Front. Neurol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"619","DOI":"10.1056\/NEJM198303173081103","article-title":"Cerebral arterial spasm\u2014A controlled trial of nimodipine in patients with subarachnoid hemorrhage","volume":"308","author":"Allen","year":"1983","journal-title":"N. Engl. J. Med."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"121","DOI":"10.3171\/JNS-07\/07\/0121","article-title":"Effect of delayed cerebral vasospasm on cerebrovascular endothelin A receptor expression and function","volume":"107","author":"Vatter","year":"2007","journal-title":"J. Neurosurg."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"415","DOI":"10.3109\/02688691003746274","article-title":"Standard intracranial in vivo animal models of delayed cerebral vasospasm","volume":"24","author":"Marbacher","year":"2010","journal-title":"Br. J. Neurosurg."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"3230","DOI":"10.1161\/STROKEAHA.112.669788","article-title":"Impairment of cerebral autoregulation predicts delayed cerebral ischemia after subarachnoid hemorrhage: A prospective observational study","volume":"43","author":"Budohoski","year":"2012","journal-title":"Stroke"},{"key":"ref_12","first-page":"177","article-title":"Endothelin related pathophysiology in cerebral vasospasm: What happens to the cerebral vessels?","volume":"110","author":"Vatter","year":"2011","journal-title":"Acta Neurochir. Suppl."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"151","DOI":"10.1179\/174313209X393564","article-title":"Cerebral vasospasm following subarachnoid hemorrhage: Time for a new world of thought","volume":"31","author":"Pluta","year":"2009","journal-title":"Neurol. Res."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1007\/s12035-010-8155-z","article-title":"Metamorphosis of subarachnoid hemorrhage research: From delayed vasospasm to early brain injury","volume":"43","author":"Sehba","year":"2011","journal-title":"Mol. Neurobiol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"669","DOI":"10.1007\/s12975-014-0369-3","article-title":"The rabbit shunt model of subarachnoid haemorrhage","volume":"5","author":"Marbacher","year":"2014","journal-title":"Transl. Stroke Res."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1014","DOI":"10.3171\/2009.3.JNS081660","article-title":"Attenuation of subarachnoid hemorrhage-induced apoptotic cell death with 17 beta-estradiol. Laboratory investigation","volume":"111","author":"Lin","year":"2009","journal-title":"J. Neurosurg."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"433","DOI":"10.1093\/cvr\/3.4.433","article-title":"Electrocardiographic changes and tissue catecholamines in experimental subarachnoid haemorrhage","volume":"3","author":"Offerhaus","year":"1969","journal-title":"Cardiovasc. Res."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"620","DOI":"10.1161\/01.STR.32.3.620","article-title":"Effects of aging on cerebral vasospasm after subarachnoid hemorrhage in rabbits","volume":"32","author":"Nakajima","year":"2001","journal-title":"Stroke"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"227","DOI":"10.1016\/j.jneumeth.2010.07.004","article-title":"Extra-intracranial blood shunt mimicking aneurysm rupture: Intracranial-pressure-controlled rabbit subarachnoid hemorrhage model","volume":"191","author":"Marbacher","year":"2010","journal-title":"J. Neurosci. Methods"},{"key":"ref_20","first-page":"e52132","article-title":"The rabbit blood-shunt model for the study of acute and late sequelae of subarachnoid hemorrhage: Technical aspects","volume":"92","author":"Andereggen","year":"2014","journal-title":"J. Vis. Exp."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"24","DOI":"10.1016\/j.amsu.2017.05.004","article-title":"Transauricular intra-arterial and intravenous digital subtraction angiography for abdominal aortic aneurysm imaging in a rabbit model","volume":"18","author":"Bi","year":"2017","journal-title":"Ann. Med. Surg."},{"key":"ref_22","first-page":"1700","article-title":"Intra-arterial digital subtraction angiography through the ear artery for experimental aneurysm imaging","volume":"27","author":"Ding","year":"2006","journal-title":"AJNR Am. J. Neuroradiol."},{"key":"ref_23","first-page":"1964","article-title":"Contrast injection via the central artery of the left ear in rabbits: A new technique to simplify follow-up studies","volume":"26","author":"Miskolczi","year":"2005","journal-title":"AJNR Am. J. Neuroradiol."}],"container-title":["Brain Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2076-3425\/15\/8\/826\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T18:19:44Z","timestamp":1760033984000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2076-3425\/15\/8\/826"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7,31]]},"references-count":23,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2025,8]]}},"alternative-id":["brainsci15080826"],"URL":"https:\/\/doi.org\/10.3390\/brainsci15080826","relation":{},"ISSN":["2076-3425"],"issn-type":[{"type":"electronic","value":"2076-3425"}],"subject":[],"published":{"date-parts":[[2025,7,31]]}}}