A novel model of large vessel ischemic stroke in rabbits: microcatheter occlusion of the posterior cerebral artery

Background and purpose The diagnosis and management of acute fetal posterior cerebral artery occlusion are challenging. While endovascular treatment is established for anterior circulation large vessel occlusion stroke, little is known about the course of acute fetal posterior cerebral artery occlusions. We report the clinical course, radiological findings and management considerations of acute fetal posterior cerebral artery occlusion stroke. Methods We performed a retrospective review of consecutive patients presenting with acute large vessel occlusion who underwent cerebral angiogram and/or mechanical thrombectomy between January 2015 and January 2021. Patients diagnosed with fetal posterior cerebral artery occlusion were included. Demographic data, clinical presentation, imaging findings and management strategies were reviewed. Results Between January 2015 and January 2021, three patients with fetal posterior cerebral artery occlusion were identified from 400 patients who underwent angiogram and/or mechanical thrombectomy for acute stroke (0.75%). The first patient presented with concomitant fetal posterior cerebral artery and middle cerebral artery occlusions. Thrombectomy was performed with recanalisation of the fetal posterior cerebral artery but the patient died from malignant oedema. The second patient presented with isolated fetal posterior cerebral artery occlusion. No endovascular intervention was performed and the patient was disabled from malignant posterior cerebral artery infarct. The third patient presented with carotid occlusion and was found to have fetal posterior cerebral artery occlusion after internal carotid artery recanalisation. No further intervention was performed. The patient was left with residual contralateral homonymous hemianopia and mild left sided weakness. Conclusion Fetal posterior cerebral artery occlusion is a rare, but potentially disabling, cause of ischaemic stroke. Endovascular treatment is feasible. Further investigation is needed to compare the efficacy of medical versus endovascular management strategies.

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Unusual acute ischemic stroke of the ipsilateral middle and posterior cerebral artery territory

Acta Neurologica Belgica ◽

10.1007/s13760-016-0652-z ◽

2016 ◽

Vol 117 (1) ◽

pp. 305-307 ◽

Cited By ~ 1

Author(s):

Laurens Hermie ◽

Jeroen De Groote ◽

Bert Geerts ◽

Peter Vanlangenhove

Keyword(s):

Ischemic Stroke ◽

Acute Ischemic Stroke ◽

Cerebral Artery ◽

Posterior Cerebral Artery

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Dominant Ipsilateral Posterior Cerebral Artery on Magnetic Resonance Angiography in Acute Ischemic Stroke

Cerebrovascular Diseases ◽

10.1159/000079255 ◽

2004 ◽

Vol 18 (2) ◽

pp. 91-97 ◽

Cited By ~ 3

Author(s):

Ju-Hun Lee ◽

Sun-Jung Han ◽

Woo-Youl Kang ◽

Ki Hyeong Lee ◽

Kyung-Ho Yu ◽

...

Keyword(s):

Ischemic Stroke ◽

Magnetic Resonance ◽

Magnetic Resonance Angiography ◽

Acute Ischemic Stroke ◽

Cerebral Artery ◽

Posterior Cerebral Artery

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A Novel Na + -K + -Cl − Cotransporter 1 Inhibitor STS66* Reduces Brain Damage in Mice After Ischemic Stroke

Stroke ◽

10.1161/strokeaha.118.024287 ◽

2019 ◽

Vol 50 (4) ◽

pp. 1021-1025 ◽

Cited By ~ 8

Author(s):

Huachen Huang ◽

Mohammad Iqbal H. Bhuiyan ◽

Tong Jiang ◽

Shanshan Song ◽

Sandhya Shankar ◽

...

Keyword(s):

Ischemic Stroke ◽

Middle Cerebral Artery ◽

Middle Cerebral Artery Occlusion ◽

Cerebral Artery ◽

Infarct Volume ◽

Artery Occlusion ◽

Large Vessel ◽

Neurological Deficits ◽

Ang Ii ◽

Cerebral Artery Occlusion

Background and Purpose— Inhibition of brain NKCC1 (Na + -K + -Cl − cotransporter 1) with bumetanide (BMT) is of interest in ischemic stroke therapy. However, its poor brain penetration limits the application. In this study, we investigated the efficacy of 2 novel NKCC1 inhibitors, a lipophilic BMT prodrug STS5 (2-(Dimethylamino)ethyl 3-(butylamino)-4-phenoxy-5-sulfamoyl-benzoate;hydrochloride) and a novel NKCC1 inhibitor STS66 (3-(Butylamino)-2-phenoxy-5-[(2,2,2-trifluoroethylamino)methyl]benzenesulfonamide), on reducing ischemic brain injury. Methods— Large-vessel transient ischemic stroke in normotensive C57BL/6J mice was induced with 50-min occlusion of the middle cerebral artery and reperfusion. Focal, permanent ischemic stroke in angiotensin II (Ang II)–induced hypertensive C57BL/6J mice was induced by permanent occlusion of distal branches of middle cerebral artery. A total of 206 mice were randomly assigned to receive vehicle DMSO, BMT, STS5, or STS66. Results— Poststroke BMT, STS5, or STS66 treatment significantly decreased infarct volume and cerebral swelling by ≈40% to 50% in normotensive mice after transient middle cerebral artery occlusion, but STS66-treated mice displayed better survival and sensorimotor functional recovery. STS5 treatment increased the mortality. Ang II–induced hypertensive mice exhibited increased phosphorylatory activation of SPAK (Ste20-related proline alanine-rich kinase) and NKCC1, as well as worsened infarct and neurological deficit after permanent distal middle cerebral artery occlusion. Conclusions— The novel NKCC1 inhibitor STS66 is superior to BMT and STS5 in reducing ischemic infarction, swelling, and neurological deficits in large-vessel transient ischemic stroke, as well as in permanent focal ischemic stroke with hypertension comorbidity.

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Posterior cerebral artery ischemic stroke in a patient with hypoplastic P1 segment of the posterior cerebral artery

Nigerian Journal of Medicine ◽

10.4103/njm.njm_91_20 ◽

2020 ◽

Vol 29 (3) ◽

pp. 520

Author(s):

AbiodunIdowu Okunlola ◽

Tayo Ibrahim ◽

TimothyOladele Majengbasan ◽

CeciliaKehinde Okunlola ◽

OlakunleFatai Babalola

Keyword(s):

Ischemic Stroke ◽

Cerebral Artery ◽

Posterior Cerebral Artery

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Abstract 3616: A Novel Model of Large Vessel Ischemic Stroke in New Zealand White Rabbits: Microcatheter Occlusion of the Posterior Cerebral Artery

Stroke ◽

10.1161/str.43.suppl_1.a3616 ◽

2012 ◽

Vol 43 (suppl_1) ◽

Author(s):

Joey English ◽

Steven Hetts ◽

Alex El-Ali ◽

Pallav Kolli ◽

Loi Do ◽

...

Keyword(s):

New Zealand ◽

Cerebral Artery ◽

Posterior Cerebral Artery ◽

Rabbit Model ◽

Large Vessel ◽

Subcortical Structures ◽

Vessel Occlusion ◽

New Zealand White Rabbits ◽

Cortical Ischemia ◽

Imagej Software

Introduction: The rabbit small clot embolic model for large vessel occlusion (LVO) is well established, yet remains with limitations. Blind introduction of autologous thrombus often fails to occlude the target vessel, and when successful, the precise timing of occlusion and revascularization are difficult to control. Studies of cellular biology and neuroimaging of acute reversible cerebral ischemia (i.e., penumbral tissue) would benefit from a rabbit model in which LVO can be reliably induced and easily confirmed, where the time of occlusion and revascularization can be precisely controlled. Hypothesis: We hypothesized that microcatheterization of the posterior cerebral artery (PCA) in New Zealand white rabbits (NZWRs) would result in LVO, with time of revascularization controlled by microcatheter removal. We hypothesized that transient LVO would produce ischemia in subcortical structures supplied by the PCA (e.g., hippocampus), sparing the cortex, with longer duration LVO leading to irreversible cortical ischemia. Methods: Transfemoral 1.5F microcatheterization of the PCA was performed in anesthetized NZWRs using fluoroscopic guidance. LVO was maintained for 30 minutes (n=2), 60 minutes (n=2), 180 minutes (n=2) and 210 minutes (n=1), followed by microcatheter removal and reperfusion. Neuroimaging was obtained 3 hours later with MRI (3T DWI, FLAIR, gradient and perfusion sequences) and CT (64 slice noncontrast and perfusion imaging). Post-mortem histologic analysis of infarct was assessed using triphenyltetrazolium choloride (TTC) stain. Matched DWI and TTC sections were analyzed using ImageJ software. Results: Percent infarct of matched DWI and TTC sections was strongly correlated (r2 = 0.86). Transient LVO of 30-60 minutes resulted in infarction of the ipsilateral hippocampus and thalamus, sparing the cortex, while more prolonged LVO (180-210 minutes) led to cortical infarction as well. Conclusions: Image-guided microcatheter induction of LVO in NZW rabbits can reliably produce time-dependent infarction of cortical and subcortical structures, and thus may be a useful model for the study of penumbral cortical tissue.

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Mechanical thrombectomy in isolated large vessel posterior cerebral artery occlusions

Neuroradiology ◽

10.1007/s00234-020-02505-w ◽

2020 ◽

Author(s):

Muhammad Zeeshan Memon ◽

Marina Kushnirsky ◽

Marie Christine Brunet ◽

Vasu Saini ◽

Sebastian Koch ◽

...

Keyword(s):

Cerebral Artery ◽

Mechanical Thrombectomy ◽

Posterior Cerebral Artery ◽

Large Vessel

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Is a fetal origin of the posterior cerebral artery a risk factor for TIA or ischemic stroke?

Journal of Neurology ◽

10.1007/s00415-008-0699-8 ◽

2008 ◽

Vol 255 (2) ◽

pp. 239-245 ◽

Cited By ~ 20

Author(s):

C. Monyé ◽

D. W. J. Dippel ◽

T. A. M. Siepman ◽

M. L. Dijkshoorn ◽

H. L. J. Tanghe ◽

...

Keyword(s):

Risk Factor ◽

Ischemic Stroke ◽

Cerebral Artery ◽

Posterior Cerebral Artery ◽

Fetal Origin

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Optional Endovascular Therapy of Dissecting Posterior Cerebral Artery Aneurysm

Interventional Neurology ◽

10.1159/000477360 ◽

2017 ◽

Vol 6 (3-4) ◽

pp. 219-228 ◽

Cited By ~ 3

Author(s):

Mohamed Wael Osman ◽

Krzysztof Kadziolka ◽

Laurent Peirot

Keyword(s):

Ischemic Stroke ◽

Cerebral Artery ◽

Endovascular Therapy ◽

Posterior Cerebral Artery ◽

Artery Aneurysm ◽

Occurrence Rate ◽

Parent Artery ◽

Safe Method ◽

First Case ◽

History Of

Background: Posterior cerebral artery aneurysms are uncommon, with an occurrence rate of less than 1% of intracranial aneurysms. They have various shapes, including saccular and fusiform. Dissecting aneurysms may occur in distal posterior cerebral artery and they may affect the whole artery. Endovascular therapy is considered as a safe method of treatment and there are different techniques for endovascular therapy. Summary: Posterior cerebral artery aneurysms are uncommon. Endovascular therapy is considered as a safe method of treatment and there are different techniques for endovascular therapy. We present here three cases collected from Maison Blanche Hospital (Intervention Neuroradiology Department, CHU Reims, France) during 2011-2012; they were females, at a young age and the affected side was on the right. The first case was affected at the P2-P3 segment, the aneurysm was fusiform in shape and she presented with ischemic stroke, while the second and third cases were affected at the P2 segment, the aneurysms being saccular in shape; one of them presented with subarachnoid hemorrhage with a history of migraine and the other patient presented with ischemic stroke. All of them had no history of trauma, hypertension or other diseases. One patient was treated by coiling and sacrificing the parent artery, the second patient was treated with stent-assisted coils, and the third one was treated by coiling without sacrificing the parent artery.

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Fetal variant of posterior cerebral artery: just a physiologic variant or a window for possible ischemic stroke?

Neurological Sciences ◽

10.1007/s10072-020-05018-9 ◽

2021 ◽

Author(s):

Martina Di Pietro ◽

Vincenzo Di Stefano ◽

Roberto Cannella ◽

Francesco Di Blasio ◽

Maria Vittoria De Angelis

Keyword(s):

Ischemic Stroke ◽

Cerebral Artery ◽

Posterior Cerebral Artery

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