Implanted pulsatile balloon device for simulation of neurovascular compression syndromes in animals

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Abstract
A self-contained neurovascular compression simulator (NCS) has been designed to function as an artificial artery that pulsates with the heart. When implanted in animals, this device simulates those naturally occurring situations in which there is compression of nervous elements in the region of the brain stem or other areas by aberrant, or ectatic branches of normal arteries. The NCS consists of an intra-aortic balloon, a smaller (cephalic) balloon, a connecting tube, and an injection port, all fabricated of polyurethane-silicone compounds. With each heart systole, the rise in intra-aortic pressure is transmitted to the smaller cephalic balloon in the form of a pulsation. Thus, part of the cardiac ejection energy is transferred to the desired nervous structures. The performance of each NCS is tested in vitro in a pulse duplicator system. The NCS was chronically implanted for up to 2 years in four dogs and 10 baboons. The cephalic balloon was placed intracranially in the subarachnoid space on the ventrolateral medulla adjacent to the entry zone of the ninth and 10th cranial nerves on the left side of baboons and on the right side of dogs. The position of the balloons was checked by fluoroscopy. Following implantation, the NCS could be inflated or deflated at will using the injection port which served to restart or discontinue the pulsations. No occlusion of the aorta or reduction of blood flow to the lower limbs or trunk was detected. By means of the NCS, an experimental model of neurogenic hypertension was produced in baboons.