Abstract P784: A Novel Rat Model of Embolic Cerebral Ischemia Using a Cell-Implantable Radiopaque Hydrogel Micro Fiber

Stroke ◽  
2021 ◽  
Vol 52 (Suppl_1) ◽  
Author(s):  
Teppei Komatsu ◽  
Hiroki Ohta ◽  
Naoki Takakura ◽  
Tomomichi Kitagawa ◽  
Junichi Hata ◽  
...  
Keyword(s):  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Rat Model ◽  
Anterior Cerebral Artery ◽  
Interquartile Range ◽  
Left Internal Carotid Artery ◽  
Left Middle Cerebral Artery ◽  
Stroke Model ◽  
Tetrazolium Chloride ◽  
A Cell

Introduction: The failure of neuroprotective treatment-related clinical trials may be partially caused by unestablished animal models. We aimed to develop a novel focal stroke model using a cell-implantable radiopaque hydrogel micro fiber. The micro fiber is made of barium alginate hydrogel containing zirconia, and fabricated in a dual coaxial laminar flow microfluidic device. Methods: Using male Sprague Dawley rats (n=10), a catheter (ID 0.42mm, OD 0.55mm) was navigated from the caudal ventral artery to the left internal carotid artery using digital subtraction angiography. A radiopaque hydrogel micro fiber (0.4 mm in diameter, 1 mm in length) was advanced in the catheter by slow injection of heparinized physiological saline to establish local occlusion. 9.4-T MRI and 2% 2,3,5-triphenyl tetrazolium chloride staining were performed 24 hours after the creation of the stroke model. Results: The anterior cerebral artery-middle cerebral artery bifurcation was selectively embolized at all rats. The median operating time was 8.5 min (interquartile range; 6.25-12 min). The median infarct volume (mm 3 ) was 262 (interquartile range; 260-274) 24 hours after occlusion. Conclusions: We present a novel rat model for focal infarct only in the middle cerebral artery territory using a radiopaque hydrogel micro fiber. Furthermore, this model can be used for regeneration research of cerebral infarction because the hydrogel micro fiber can encapsulate stem cell.Figure Legends A: Puncture of the caudal ventral artery in a rat. B: Cerebral angiography of a rat. C: Occlusion of the anterior cerebral artery-middle cerebral artery bifurcation by a radiopaque hydrogel fiber (arrowhead). D: MR angiography detected selective occlusion of left middle cerebral artery. E: T2-weighted image showed infarct only in the middle cerebral artery after 24 hours occlusion. A radiopaque fiber did not affect the 9.4-T MRI. F: Radiopaque hydrogel fiber encapsulated HeLa cells.

scholarly journals A novel model of ischemia in rats with middle cerebral artery occlusion using a microcatheter and zirconia ball under fluoroscopy

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Teppei Komatsu ◽  
Hiroki Ohta ◽  
Haruhiko Motegi ◽  
Junichi Hata ◽  
Koshiro Terawaki ◽  
...  
Keyword(s):  
Animal Models ◽  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Zirconium Dioxide ◽  
Operating Time ◽  
Interquartile Range ◽  
Left Internal Carotid Artery ◽  
Tetrazolium Chloride ◽  
Mca Occlusion ◽  
Hemorrhagic Complications

AbstractThe failure of neuroprotective treatment-related clinical trials may be partially caused by unestablished animal models. Existing animal models are less likely to provide occlusion confined to the middle cerebral artery (MCA), making transarterial intervention difficult. We aimed to develop a novel focal stroke model using a microcatheter and zirconium dioxide that is non-magnetic under fluoroscopic guidance, which can monitor MCA occlusion and can improve hemorrhagic complications. Using male Sprague Dawley rats (n = 10), a microcatheter was navigated from the caudal ventral artery to the left internal carotid artery using an X-ray fluoroscopy to establish local occlusion. All rat cerebral angiographies were successful. No rats had hemorrhagic complications. Eight (80%) rats underwent occlusion of the MCA bifurcation by zirconium dioxide. Accidentally, the left posterior cerebral artery was failure embolized in 2 rats (20%). The median operating time was 8 min. All rats of occlusion MCA revealed an incomplete hemiparesis on the right side with neurological deficit score ranging from 1 to 3 (median 1, interquartile range 1–3) at 24 h after the induction of ischemia. Moreover, 2% 2,3,5-triphenyl tetrazolium chloride staining showed that the median infarct volume (mm3) was 280 (interquartile range 267–333) 24 h after the left MCA bifurcation occlusion. We present a novel rat model for focal stroke using a microcatheter and zirconium dioxide which does not affect the MRI. The model is predictable which is well confined within the territory supplied by the MCA, and reproducibility of this model is 80%. Fluoroscopy was able to identify which the MCA occlusion and model success while creating the model. It permitted exclusion of animals with complications from the experiment.

scholarly journals Stent-Assisted Coiling of a Sidewall Aneurysm of the Distal Middle Cerebral Artery: 2-Dimensional Operative Video

2020 ◽  
Vol 20 (1) ◽  
pp. E37-E38
Author(s):  
Daniel D Cavalcanti ◽  
Nader Delavari ◽  
Howard A Riina ◽  
Adam Arthur ◽  
Mark Bain ◽  
...  
Keyword(s):  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Incidental Finding ◽  
Endovascular Coiling ◽  
Left Internal Carotid Artery ◽  
Left Middle Cerebral Artery ◽  
Recurrence Rates ◽  
Complex Partial Seizures ◽  
Transfemoral Approach ◽  
Cerebral Angiogram

Abstract Sidewall aneurysm treatment often requires complex management strategies. These can include advanced clipping techniques or stent-assisted coiling techniques. Endovascular coiling alone has been associated with high recurrence rates and is often not feasible.1-4 Flow-diversion embolization has recently become a standard of care for many aneurysms, demonstrating high occlusion rates.4,5 However, the third generation of coil-assist stents can be delivered with 0.0165” microcatheters, being an ideal adjunct to manage this group of aneurysms in more distal locations. In this video, a 16-yr-old teenager with Parry-Romberg syndrome and congenital adrenal hyperplasia had an incidental finding of a 6.5-mm sidewall aneurysm arising off the angular branch of the left middle cerebral artery, found during the work-up of complex partial seizures. The patient consented to the procedure. Due to his young age and aneurysm size, a decision was made to treat the aneurysm through an endovascular approach. Under general anesthesia, a transfemoral approach was carried out using a 6-French short sheath. A 6-French guiding catheter was left in the distal cervical left internal carotid artery; a 0.0165” microcatheter was used to first deploy a 3.0 × 15 mm Neuroform Atlas stent, completely covering the length of the aneurysm. Then, the stent was traversed with the microcatheter to coil the aneurysm. Follow-up cerebral angiogram confirmed complete occlusion of the aneurysm.

scholarly journals Transcranial doppler in sickle cell anaemia: evaluation of brain blood flow parameters in children of Aracaju, Northeast - Brazil

2008 ◽  
Vol 66 (2b) ◽  
pp. 360-364 ◽  
Author(s):  
Hyder Aragão de Melo ◽  
José Augusto S. Barreto-Filho ◽  
Roberto César P. do Prado ◽  
Rosana Cipolotti
Keyword(s):  
Middle Cerebral Artery ◽  
Sickle Cell ◽  
Cerebral Artery ◽  
Sickle Cell Anaemia ◽  
Anterior Cerebral Artery ◽  
International Standards ◽  
Left Middle Cerebral Artery ◽  
Mean Velocity ◽  
Cross Sectional ◽  
Left Middle

BACKGROUND: Environmental factors interfere on sickle cell anaemia (SCA). Transcanial Doppler (TCD) is important to evaluate cerebrovascular disease. OBJECTIVE: To evaluate brain haemodynamic profile of children with SCA in Sergipe. METHODS: Cross sectional study (group1: SCA patients aged 3-18; group2: age and sex matched healthy individuals). Baseline brain flow was evaluated. RESULTS: Group1=34 patients; group 2=81 controls. SCA patients had mean velocity (MV)=125.69 cm/s±23.40; pulsatility index (PI)=0.66±0.10; middle cerebral artery ratio (MCAr)=14.53±15.23; right anterior cerebral artery/right middle cerebral artery=0.77±0.20; left anterior cerebral artery/left middle cerebral artery=0.78±0.20. Controls had MV=79.44±15.54; PI=0.82±0.11; MCAr=13.19±13.77; right anterior cerebral artery/right middle cerebral artery=0.80±0.16; left anterior cerebral artery/left middle cerebral artery=0.84±0.18. MV and PI differences were statistically significant between groups. MV was related to age but not to gender. CONCLUSION: MV evaluation using TCD was similar to international standards and possible to be used in our setting.

scholarly journals A Novel Rat Model of Embolic Cerebral Ischemia Using a Microcatheter and Zirconia Ball Under Fluoroscopic Guidance

2021 ◽  
Author(s):  
Teppei Komatsu ◽  
Hiroki Ohta ◽  
Haruhiko Motegi ◽  
Junichi Hata ◽  
Koshiro Terawaki ◽  
...  
Keyword(s):  
Animal Models ◽  
Cerebral Artery ◽  
Rat Model ◽  
Zirconium Dioxide ◽  
Operating Time ◽  
Left Internal Carotid Artery ◽  
Fluoroscopic Guidance ◽  
Tetrazolium Chloride ◽  
Mca Occlusion ◽  
Hemorrhagic Complications

Abstract Background and Purpose: The failure of neuroprotective treatment-related clinical trials may be partially caused by unestablished animal models. Existing animal models are less likely to provide occlusion confined to the middle cerebral artery (MCA), making transarterial intervention difficult. We aimed to develop a novel focal stroke model using a microcatheter and zirconium dioxide that is non-magnetic under fluoroscopic guidance, which can monitor MCA occlusion and can improve hemorrhagic complications. Methods: Using male Sprague Dawley rats (n=8), a microcatheter was navigated from the caudal ventral artery to the left internal carotid artery using digital subtraction angiography to establish local occlusion. Results: All rat cerebral angiographies were successful. No rats had hemorrhagic complications. Six (75%) rats underwent occlusion of the MCA bifurcation by zirconium dioxide. Accidentally, the left posterior cerebral artery was failure embolized in 2 rats (25%) via the posterior communicating artery. The median operating time was 8.5 min. Moreover, 2% 2,3,5-triphenyl tetrazolium chloride staining showed that the median infarct volume (mm3) was 280 (interquartile range; 267-333) 24 hours after the left MCA bifurcation occlusion. Conclusions: We present a novel rat model for focal stroke using a microcatheter and zirconium dioxide which does not affect the MRI. The model is predictable and reproducible, which is well confined within the territory supplied by the MCA. Fluoroscopy was able to identify which the MCA occlusion and model success while creating the model. It permitted exclusion of animals with complications from the experiment.

scholarly journals Brain abscess after stent-assisted coiling for ruptured middle cerebral artery aneurysm

2018 ◽  
Vol 24 (4) ◽  
pp. 387-391 ◽  
Author(s):  
Jung Ho Ko ◽  
Young-Joon Kim ◽  
Hyun Ho Jung
Keyword(s):  
Staphylococcus Aureus ◽  
Central Venous Catheter ◽  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Venous Catheter ◽  
Nausea And Vomiting ◽  
Left Internal Carotid Artery ◽  
Left Middle Cerebral Artery ◽  
Central Venous ◽  
Brain Ct

A 24-year-old man was admitted with sudden severe headache. Brain computed tomography (CT) revealed a subarachnoid hemorrhage in the basal cistern and both Sylvian cisterns and a left internal carotid artery angiogram showed a small aneurysm on the bifurcation of the left middle cerebral artery. We performed Y-configured stent-assisted coil embolization. On the fifth post-embolization day, the patient had chills, and his body temperature was over 38℃. Staphylococcus aureus was cultured from the venous blood sample. Central venous catheter-induced bacteremia was suspected. The central venous catheter was immediately removed, and an antibiotic to which the organism was susceptible (nafcillin) was injected for 15 days according to the result of the antibiotics sensitivity test. He was discharged without any clinical or neurological symptoms on the 32nd hospital day. Three months after treatment, the patient complained in the outpatient department of headache, nausea and vomiting. Brain magnetic resonance imaging showed several well-rimmed enhancing lesions in the left temporoparietal lobe. The headache, nausea and vomiting was aggravated, and brain CT showed more enlarging cysts and aggravation of the midline shift. Stereotactic aspiration was performed for the three biggest cysts, and greenish-white colored pus was aspirated. The identified pathogen was methicillin-sensitive Staphylococcus aureus in the culture study. Vancomycin and ceftriaxone were administered intravenously for three weeks, followed by intravenous injection of nafcillin for five weeks. The patient’s postoperative course was clinically uneventful, and brain CT on postoperative day 57 showed total disappearance of the rim-enhanced abscess.

Abstract 1122‐000164: Peri‐embolization Use of Stent Retrievers as a Rescue Tool in Patients with Subarachnoid Hemorrhage

2021 ◽  
Vol 1 (S1) ◽  
Author(s):  
Abdallah O Amireh ◽  
Muhammad Nagy ◽  
Hassan Ali ◽  
Siddhart Mehta ◽  
Haralabos Zacharatos ◽  
...  
Keyword(s):  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Coil Embolization ◽  
Stent Retriever ◽  
Left Internal Carotid Artery ◽  
Left Middle Cerebral Artery ◽  
Primary Coil ◽  
Mechanical Removal ◽  
Stent Retrievers ◽  
Coil Migration

Introduction : Coil migration after endovascular embolization of intracranial aneurysms is one of the periprocedural complications in 2–6% of patients. Stent retriever use is well‐established in treatment of ischemic stroke but has not been well established to address coil retrieval as rescue therapy. We describe three cases with successful removal of migrated coils using stent retrievers. Methods : A retrospective review at a single center university hospital was performed for all Neuro‐endovascular case log from December 2018 to November 2020. Cases of coil migration were reviewed and coil retraction with Stent Retriever with successful coil mass extraction was considered an endpoint. Number of attempts, types of stent retrievers used and time taken for extraction were noted. Results : Case 1: 56‐year‐old female presented with ruptured tri‐lobed 4 × 3 mm Anterior communicating artery aneurysm. Hunt and Hess (H&H) Grade 2. Modified Fisher scale (MFS) 4. Underwent primary coil embolization. Two 2mmx2cm Galaxy Orbit coils were deployed within aneurysm. During deployment of third coil the first two coils displaced out of the aneurysm migrating into left A2 segment. Stryker’s Trevo 3 × 20 mm stent retriever was used for retrieval of coils however they dislodged at the left internal carotid artery (ICA) terminus and migrated distally into the left middle cerebral artery (MCA) M2 superior division. Subsequently, Medtronic’s Solitaire 4 × 40 mm stent retriever was successfully deployed retrieving the migrated coils with full recanalization. Case 2: 64‐year‐old female presented with ruptured 3 × 5.3 mm right posterior communicating artery (Pcom) aneurysm. H&H 5 and MFS 4. Underwent primary coil embolization with placement of Galaxy Orbit 2.5mmx3.5cm coil. On follow up run, coil mass had migrated into the origin of right fetal Pcom. Migrated coil was successfully retrieved using Stryker’s 4 × 40 mm stent retriever with complete recanalization. Case 3: 65‐year‐old female with presented ruptured 8.5 × 6.8 mm right supraclinoid ICA irregular aneurysm. H&H Grade 1. MFS 3. Underwent primary coil embolization with one Galaxy coil (5mm x 10cm) with plan for future flow diversion. Two weeks later, patient experienced acute neurological worsening with new left sided hemiparesis and right gaze deviation. Imaging revealed acute occlusion of right middle cerebral artery M1 segment occlusion with thrombosed migrated coil. Patient underwent retrieval of the coil and superimposed thrombus utilizing Stryker’s Trevo (4*30 mm) stent retriever with resultant full recanalization. Conclusions : These cases demonstrate successful endovascular mechanical removal of migrated coils using stent retrievers. They add to the limited experience of stent retrievers utilization as effective tools for dealing with such complications.

scholarly journals TRANSCRANIAL DOPPLER PADA SEREBRAL ARTERIOVENOUS MALFORMATION LAPORAN KASUS

2017 ◽  
Vol 2 (1) ◽  
pp. 307
Author(s):  
Esdras Ardi Pramudita
Keyword(s):  
Arteriovenous Malformation ◽  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Transcranial Doppler ◽  
Pulsatility Index ◽  
Anterior Cerebral Artery ◽  
Left Middle Cerebral Artery ◽  
Mean Flow ◽  
Left Middle ◽  
Mean Flow Velocity

Serebral Arteriovenous Malformation (AVM) merupakan suatu kelainan pada formasi pembuluh darah di otak. Keadaan dinding pembuluh darah yang terbentuk pada AVM tidak sebaik dengan pembuluh darah normal sehingga mudah pecah dan menimbulkan masalah intraserebral. TCD merupakan suatu pemeriksaan berbasis ultrasound yang bersifat non invasif, murah dan real time dalam memeriksa kondisi hemodinamik intraserebral dan TCD dapat digunakan untuk menentukan feeder artery pada serebral AVM. Melaporkan dua kasus Serebral AVM selama bulan Juli-September 2016 di RS Panti Rapih Yogyakarta dari kedua kasus didapatkan peningkatan Mean Flow Velocity (MFV) dan penurunan Pulsatility Index (PI) <0,5 pada Right Anterior Cerebral Artery (R-ACA) dari kasus pertama dan Left Middle Cerebral Artery (L-MCA) dari kasus kedua yang menunjukkan bahwa arteri-arteri ini sebagai feeder artery

scholarly journals Post-stroke cognitive impairment on the Mini-Mental State Examination primarily relates to left middle cerebral artery infarcts

2021 ◽  
pp. 174749302098455
Author(s):  
Nick A Weaver ◽  
Angelina K Kancheva ◽  
Jae-Sung Lim ◽  
J Matthijs Biesbroek ◽  
Irene MC Huenges Wajer ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Cognitive Deficits ◽  
Mini Mental State Examination ◽  
Left Middle Cerebral Artery ◽  
Post Stroke ◽  
Lesion Symptom Mapping ◽  
State Examination ◽  
Left Middle

Background Post-stroke cognitive impairment can occur after damage to various brain regions, and cognitive deficits depend on infarct location. The Mini-Mental State Examination (MMSE) is still widely used to assess post-stroke cognition, but it has been criticized for capturing only certain cognitive deficits. Along these lines, it might be hypothesized that cognitive deficits as measured with the MMSE primarily involve certain infarct locations. Aims This comprehensive lesion-symptom mapping study aimed to determine which acute infarct locations are associated with post-stroke cognitive impairment on the MMSE. Methods We examined associations between impairment on the MMSE (<5th percentile; normative data) and infarct location in 1198 patients (age 67 ± 12 years, 43% female) with acute ischemic stroke using voxel-based lesion-symptom mapping. As a frame of reference, infarct patterns associated with impairments in individual cognitive domains were determined, based on a more detailed neuropsychological assessment. Results Impairment on the MMSE was present in 420 patients (35%). Large voxel clusters in the left middle cerebral artery territory and thalamus were significantly (p < 0.01) associated with cognitive impairment on the MMSE, with highest odds ratios (>15) in the thalamus and superior temporal gyrus. In comparison, domain-specific impairments were related to various infarct patterns across both hemispheres including the left medial temporal lobe (verbal memory) and right parietal lobe (visuospatial functioning). Conclusions Our findings indicate that post-stroke cognitive impairment on the MMSE primarily relates to infarct locations in the left middle cerebral artery territory. The MMSE is apparently less sensitive to cognitive deficits that specifically relate to other locations.

Multiple middle cerebral artery aneurysms in an infant

1990 ◽  
Vol 72 (5) ◽  
pp. 806-809 ◽  
Author(s):  
Cornelia Cedzich ◽  
J. Schramm ◽  
G. Röckelein
Keyword(s):  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Systemic Disease ◽  
Intracerebral Hematoma ◽  
Left Middle Cerebral Artery ◽  
Content Type ◽  
Middle Cerebral Artery Aneurysms ◽  
Subarachnoid Blood ◽  
Left Middle ◽  
Control Angiography

✓ An 11-month-old boy was admitted for evaluation of drowsiness, vomiting, and convulsions. Computerized tomography showed subarachnoid blood in the left sylvian fissure and a small intracerebral hematoma in the temporal lobe. Angiography revealed several aneurysms of the left middle cerebral artery (MCA). During surgery, 13 aneurysms were found arising from one main branch of the left MCA, and this segment of the MCA was trapped. Somatosensory evoked potentials did not show any change during surgery. The diseased arterial segment was examined histologically and the pathogenetic aspects of the case are discussed. Control angiography 6 months later excluded systemic disease or other aneurysms. The rarity of such lesions in childhood and their successful surgical treatment are discussed briefly.

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