Background Rete mirabile (RM) of the domestic pig is a popular animal model of arteriovenous malformations. The RM (Latin for ‘wonderful net)’ comprises the arterioarterial portal connecting ascending pharyngeal arteries and the internal carotid arteries, which exists in the skull base of even-toed ungulates. Although angiographic access of the RM is relatively easy, its post mortem procurement is complicated and its detailed technique has not been well described.
Objective To present our focused post mortem dissection technique for undamaged and complete harvest of the RM.
Materials and methods Fourteen domestic (40–70 lb (18–32 kg)) swine were used in this study. Angiographies were performed under general anesthesia in all animals. A 5F Berenstein catheter was used for angiography and a 014 microcatheter was used to obtain superselective angiography. A stepwise surgical dissection technique has been developed to efficiently harvest RM. Angiographic and surgical anatomy were also compared.
Results The RM was supplied by bilateral ascending pharyngeal arteries. Bilateral anterior cerebral arteries, middle cerebral arteries, and the basilar system were identified rostral to the RM. Our surgical dissection technique was developed during a project to streamline harvesting of the RM and a stepwise description is as follows: (1) decapitate the swine by removing the head through the plane of the occiput and C1 vertebral body; (2) remove the tongue and oropharynx via a ventral approach; (3) dissect through the posterior pharyngeal wall identifying bilateral tympanic bullae and the basisphenoid bone; and (4) remove the basisphenoid bone about one and half inches above the rostral end of the tympanic bullae to fully expose the rete.
Conclusions The RM can be procured efficiently and effectively with our technique, without requiring any sophisticated surgical devices.
- Arteriovenous Malformation