scholarly journals A Novel Thromboplastin-Based Rat Model of Ischemic Stroke

2021 ◽  
Vol 11 (11) ◽  
pp. 1475
Author(s):  
Irina V. Ostrova ◽  
Sergei N. Kalabushev ◽  
Ivan A. Ryzhkov ◽  
Zoya I. Tsokolaeva
Keyword(s):  
Ischemic Stroke ◽  
Carotid Artery ◽  
Histological Examination ◽  
Blood Clot ◽  
Brain Infarction ◽  
Neurological Status ◽  
External Carotid ◽  
Left Internal Carotid Artery ◽  
Maxillary Artery ◽  
Stroke Model

The thromboembolic ischemia model is one of the most applicable for studying ischemic stroke in humans. The aim of this study was to develop a novel thromboembolic stroke model, allowing, by affordable tools, to reproduce cerebral infarction in rats. In the experimental group, the left common carotid artery, external carotid artery, and pterygopalatine branch of maxillary artery were ligated. A blood clot that was previously formed (during a 20 min period, in a catheter and syringe, by mixing with a thromboplastin solution and CaCl2) was injected into the left internal carotid artery. After 10 min, the catheter was removed, and the incision was sutured. The neurological status of the animals was evaluated using a 20-point scale. Histological examination of brain tissue was performed 6, 24, 72 h, and 6 days post-stroke. All groups showed motor and behavioral disturbances 24 h after surgery, which persisted throughout the study period. A histological examination revealed necrotic foci of varying severity in the cortex and subcortical regions of the ipsilateral hemisphere, for all experimental groups. A decrease in the density of hippocampal pyramidal neurons was revealed. Compared with existing models, the proposed ischemic stroke model significantly reduces surgical time, does not require an expensive operating microscope, and consistently reproduces brain infarction in the area of the middle cerebral artery supply.

scholarly journals Tactics of surgical treatment of acute brain ischemia caused by atherosclerotic damage of the brachiocephalic arteries

2020 ◽  
Vol 22 (3) ◽  
pp. 31-41
Author(s):  
V. A. Lukyanchikov ◽  
E. V. Udodov
Keyword(s):  
Ischemic Stroke ◽  
Surgical Treatment ◽  
Carotid Artery ◽  
Brain Ischemia ◽  
Neurological Status ◽  
External Carotid Artery ◽  
Acute Stage ◽  
External Carotid ◽  
Ischemic Lesion ◽  
Study Objective

The study objective is to test tactics of surgical treatment of patients with brachiocephalic artery pathology in the acute stage of ischemic stroke.Materials and methods. In the period between 01.07.2014 and 31.12.2017 at the Neurosurgery Division of the N.V. Sklifosovsky Research Institute of Emergency Medicine and the Neurosurgery Division of the N.A. Semashko Republican Clinical Hospital (Simferopol), 125 surgeries were performed in patients with occlusion and stenosis of the precerebral arteries in the acute stage of ischemic stroke. Carotid endarterectomy was performed in 69 cases, among them 54 were performed by eversion technique, 15 traditionally, in 4 cases sympathectomy of the internal carotid artery (ICA) was performed, in 4 – endarterectomy from the external carotid artery, in 3 – redirection of the ICA, in 2 – ICA prosthesis, in 9 – thrombointimectomy. Extracranial-intracranial bypass anastomosis was performed in patients with acute ICA thrombosis (n = 16) and symptomatic ICA occlusion (n = 22).Results. Good and moderate results (4–5 points per the Glasgow Outcome Scale) were achieved in 119 (95.2 %) observations. Level of consciousness impairment, evaluations per the NIHSS, Rankin, Rivermead scales, brain ischemia volume, presence of brain hypoperfusion prior to surgery, timetable of surgical intervention, postoperative characteristics of the volumetric blood flow and brain reperfusion characteristics significantly affected treatment results. Total rate of complications and deaths was 4.8 %. In 3 cases, death was caused by myocardial infarction, malignant hyperperfusion with hemorrhagic transformation of the ischemic lesion and repeat stroke.Conclusion. Surgical treatment of patients with transient ischemic attacks, acute small or completed stroke should be performed as soon as possible: this tactic decreases the risk of repeat ischemic attacks and improves functional outcomes of treatment. In case of crescendo of a transient ischemic attack or progressing stroke, surgical treatment should be postponed and performed 24 hours after stabilization of the patient’s neurological status.

scholarly journals Selective intra-carotid blood cooling in acute ischemic stroke: A safety and feasibility study in an ovine stroke model

2021 ◽  
pp. 0271678X2110249
Author(s):  
Giorgio FM Cattaneo ◽  
Andrea M Herrmann ◽  
Sebastian A Eiden ◽  
Manuela Wieser ◽  
Elias Kellner ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Carotid Artery ◽  
Acute Ischemic Stroke ◽  
Neurological Outcome ◽  
Artery Occlusion ◽  
Control Group ◽  
Stroke Model ◽  
Primary Endpoints ◽  
Neuroprotective Strategy ◽  
Vessel Patency

Selective therapeutic hypothermia (TH) showed promising preclinical results as a neuroprotective strategy in acute ischemic stroke. We aimed to assess safety and feasibility of an intracarotid cooling catheter conceived for fast and selective brain cooling during endovascular thrombectomy in an ovine stroke model. Transient middle cerebral artery occlusion (MCAO, 3 h) was performed in 20 sheep. In the hypothermia group (n = 10), selective TH was initiated 20 minutes before recanalization, and was maintained for another 3 h. In the normothermia control group (n = 10), a standard 8 French catheter was used instead. Primary endpoints were intranasal cooling performance (feasibility) plus vessel patency assessed by digital subtraction angiography and carotid artery wall integrity (histopathology, both safety). Secondary endpoints were neurological outcome and infarct volumes. Computed tomography perfusion demonstrated MCA territory hypoperfusion during MCAO in both groups. Intranasal temperature decreased by 1.1 °C/3.1 °C after 10/60 minutes in the TH group and 0.3 °C/0.4 °C in the normothermia group (p < 0.001). Carotid artery and branching vessel patency as well as carotid wall integrity was indifferent between groups. Infarct volumes (p = 0.74) and neurological outcome (p = 0.82) were similar in both groups. Selective TH was feasible and safe. However, a larger number of subjects might be required to demonstrate efficacy.

scholarly journals Dilatation of common carotid artery is strongly associated with cerebral ischemic stroke with or without the presence of carotid atherosclerosis

Stroke ◽  
2001 ◽  
Vol 32 (suppl_1) ◽  
pp. 365-365
Author(s):  
Jiunn-Rong Chen ◽  
Chyi-Huey Bai ◽  
Hou-Chang Chiu ◽  
Wen-Harn Pan
Keyword(s):  
Ischemic Stroke ◽  
Alcohol Consumption ◽  
Carotid Artery ◽  
Common Carotid Artery ◽  
Carotid Atherosclerosis ◽  
Previous History ◽  
External Carotid ◽  
Compensatory Mechanism ◽  
Plaque Score ◽  
Diabetes Status

P147 Background: Dilatation of common carotid artery (CCA) was related to age, sex, and body height in population studies. It was also considered a compensatory mechanism to carotid atherosclerotic stenosis. The present study examined the risk of CCA dilatation associated with ischemic stroke (IS) and its relations to carotid atherosclerosis, hypertension, hyperglycemia, fibrinogen, cholesterol, HDL-cholesterol (HDL-C), smoking, and alcohol consumption. Methods: A case-control study was carried on 251 first-ever IS patients (age≥40) excluding previous history of myocardial infarction and cancer and 242 non-stroke outpatients. Intraluminal diameter of middle portion of CCA, and plaque thickness in CCA, bulb, internal and external carotid arteries were measured. Information on hypertension and diabetes status and data of life-styles such as smoking and alcohol consumption were collected. Levels of fibrinogen, factor VIIIc, cholesterol, HDL-C and glucose were obtained. Results: CCA dilatation was a strong factor for IS (OR=4.13, P=0.0001). It was also associated with hypertension, hyperglycemia, smoking, alcohol consumption, low HDL-C, and high levels of fibrinogen, factor VIIIc, cholesterol, and plaque score. The association remained significant with or without each of the following conditions: hypertension (p=0.0001, p=0.0007), hyperglycemia (p=0.0446, p=0.0001), elevated fibrinogen (p=0.0104, p=0.0001) or factor VIIIc (p=0.2458, p=0.0001), hypercholesterolemia (p=0.0238, p=0.0001), decreased HDL-C (p=0.0012, p=0.0001) and presence of plaque score (p=0.0263, p=0.0003). Adjusting above risk factors, odds ratios of elevated diameter could associated with IS, before (OR=2.21, P=0.0066) and after (OR=6.63, p=0.0055) excluding subjects with plaque. Conclusion: Dilatation of CCA is a strong risk factor for IS. The fact the association remained significant without ultrasonic evidence of carotid plaque indicates that IS in Chinese involved a mechanism of active vasculopathy, not just a passive compensatory process to extracranial atherosclerosis.

scholarly journals Saphenous vein graft bypass in the treatment of giant cavernous sinus aneurysms: report of two cases

2000 ◽  
Vol 58 (1) ◽  
pp. 162-168 ◽  
Author(s):  
RICARDO RAMINA ◽  
MURILO S. MENESES ◽  
ARI A PEDROZO ◽  
WALTER O. ARRUDA ◽  
GUILHERME BORGES
Keyword(s):  
Carotid Artery ◽  
Cavernous Sinus ◽  
Saphenous Vein ◽  
Vein Graft ◽  
Saphenous Vein Graft ◽  
Brain Infarction ◽  
Superficial Temporal Artery ◽  
High Flow ◽  
Low Flow ◽  
External Carotid

Two cases of giant intracavernous aneurysms treated by high flow bypass with saphenous vein graft between the external carotid artery (ECA) and branches of the middle cerebral artery (MCA) are presented. Very often these aneurysms are unclippable because they are fusiform or have a large neck. Occlusion of the internal carotid artery (ICA) is the treatment of choice in many cases. This procedure has however a high risk of brain infarction. Revascularization of the brain by extra-intracranial anastomosis between the superficial temporal artery (STA) and branches of the MCA is frequently performed. This procedure provides however a low flow bypass and brain infarction may occur. We report two cases of giant cavernous sinus aneurysms treated by high flow bypass and endovascular balloon occlusion of the ICA. Immediate high flow revascularization of MCA branches was achieved and the patients showed no ischemic events. Follow-up of 8 and 14 months after operation shows patency of the venous graft and no neurological deficits. Angiographic control examination showed complete aneurysm occlusion in both cases.

scholarly journals Intranasal salvinorin A improves neurological outcome in rhesus monkey ischemic stroke model using autologous blood clot

2020 ◽  
pp. 0271678X2093813
Author(s):  
Longfei Wu ◽  
Di Wu ◽  
Jian Chen ◽  
Chunhua Chen ◽  
Tianqi Yao ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Rhesus Monkeys ◽  
Infarct Volume ◽  
Blood Clot ◽  
Autologous Blood ◽  
Control Group ◽  
Stroke Model ◽  
Neurological Outcomes ◽  
Observation Period ◽  
Autologous Blood Clot

Salvinorin A (SA) exerts neuroprotection and improves neurological outcomes in ischemic stroke models in rodents. In this study, we investigated whether intranasal SA administration could improve neurological outcomes in a monkey ischemic stroke model. The stroke model was induced in adult male rhesus monkeys by occluding the middle cerebral artery M2 segment with an autologous blood clot. Eight adult rhesus monkeys were randomly administered SA or 10% dimethyl sulfoxide as control 20 min after ischemia. Magnetic resonance imaging was used to confirm the ischemia and extent of injury. Neurological function was evaluated using the Non-Human Primate Stroke Scale (NHPSS) over a 28-day observation period. SA significantly reduced infarct volume (3.9 ± 0.7 cm3 vs. 7.2 ± 1.0 cm3; P =  0.002), occupying effect (0.3 ± 0.2% vs. 1.4 ± 0.3%; P =  0.002), and diffusion limitation in the lesion (−28.2 ± 11.0% vs. −51.5 ± 7.1%; P =  0.012) when compared to the control group. SA significantly reduced the NHPSS scores to almost normal in a 28-day observation period as compared to the control group ( P =  0.005). Intranasal SA reduces infarct volume and improves neurological outcomes in a rhesus monkey ischemic stroke model using autologous blood clot.

Carotid Artery Stenting under Flow Arrest for the Management of Intraluminal Thrombus: Technical Case Report

2008 ◽  
Vol 63 (suppl_1) ◽  
pp. ONSE87-ONSE88 ◽  
Author(s):  
Ramachandra P. Tummala ◽  
Babak S. Jahromi ◽  
Junichi Yamamoto ◽  
Elad I. Levy ◽  
Adnan H. Siddiqui ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Stent Placement ◽  
Internal Carotid ◽  
External Carotid ◽  
Left Internal Carotid Artery ◽  
Carotid Stent ◽  
Intraluminal Thrombus ◽  
Antegrade Flow

Abstract Objective The management of intraluminal carotid thrombus is not well defined. Medical and surgical management carry a relatively high risk of thromboembolism. Although endovascular options also carry the risk of thromboembolism from manipulation of the lesion, successful carotid stent placement using various methods of flow restriction has been reported anecdotally. We describe a technique to arrest antegrade flow before placement of carotid stents in the setting of symptomatic intraluminal thrombus. Clinical Presentation A 49-year-old woman presented with expressive dysphasia, right-upper extremity weakness, and an episode of left monocular blindness. Angiography confirmed the presence of a large intraluminal thrombus in a chronic dissection of the left internal carotid artery. Results We devised a configuration to arrest antegrade flow in the internal carotid artery before crossing the thrombus with a distal embolic protection device by inflating balloons in the common carotid artery and external carotid artery before crossing the lesion. After inflation of a balloon in the internal carotid artery, we completed overlapping stent placement to completely exclude the thrombus from the lumen. Conclusion The patient remained neurologically unchanged during and immediately after the procedure. She had mild neurological deficits at the 1 month follow-up evaluation. Follow-up ultrasonography at 1 and 3 months and computed tomographic angiography at 3 months after the procedure showed patency of the stented carotid artery, with no evidence of restenosis or thrombus. Although the risks of carotid stent placement for intraluminal thrombus remain unclear, the technique of flow arrest seems to provide a safe endovascular treatment option.

scholarly journals Emergency glomus-saving autotransplantation of the internal carotid artery in the acute period of ischemic stroke

2021 ◽  
Vol 22 (3) ◽  
pp. 38-47
Author(s):  
A. N. Kazantsev ◽  
K. P. Chernykh ◽  
S. V. Artyukhov ◽  
L. V. Roshkovskaya ◽  
M. O. Janelidze ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Postoperative Period ◽  
Internal Carotid ◽  
External Carotid ◽  
Computer Data ◽  
Acute Period ◽  
Atherosclerotic Lesions ◽  
The City

Purpose. Analysis of the immediate results of emergency glomus-sparing auto-transplantation of the internal carotid artery (ICA) in the acute period of ischemic stroke, developed on the basis of the City Alexandrovskaya Hospital, St. Petersburg.Material and methods. In this prospective, single-center study from January 2017 to August 2020. 49 patients were included in the acute period of ischemic stroke with hemodynamically significant extended atherosclerotic lesions of the ICA. All patients underwent glomus-sparing ICA autotransplantation, developed on the basis of the City Alexandrovskaya Hospital, St. Petersburg (Kazantsev A. N., Zarkua N. E., Chernykh K. P. et al. Аrteries with extended atherosclerotic lesions of the internal carotid artery. Patent application No. 202.013.4151/14 (062595), filing date 10/16/2020). Glomus-sparing ICA autotransplantation, developed on the basis of the City Alexandrovskaya Hospital, St. Petersburg, was performed as follows. On the inner edge of the external carotid artery (ECA), adjacent to the carotid sinus, 2–3 cm above the orifice, depending on the spread of atherosclerotic plaque (ASB), arteriotomy was performed with the transition to the common carotid artery (CCA) (also 2–3 see below the mouth of the NSA). The ICA was cut off at the site formed by the sections of the wall of the NSA and the CCA. Then the ICA was cut off as distally as possible in front of the hypoglossal nerve, so that the artery was completely resected. In view of the presence of an intact carotid glomus on the resected area of the ICA, which connects it to the wound, endarterectomy from the ICA was performed inside the operating field by its complete eversion. Then, open endarterectomy from ECA and CCA was performed. At the next stage, the ICA was implanted in its previous place with the creation of proximal and distal end-to-end anastomoses, so that the continuing ASB above the endarterectomy zone was fixed with a circular vascular suture.Results. There were no complications in the postoperative period. No cases of restenosis / thrombosis of the reconstruction zone were identified in all the sample according to the color duplex scanning data. On the 7th day after the operation, all patients were diagnosed with regression of neurological symptoms according to the National Institute of Health Stroke Scale: on admission, the mean score was 10.5±3.5; at the moment of the control point — 6.5±1.5; p=0.001. This reflects the effectiveness of the chosen treatment strategy. According to the data on the dynamics of systolic blood pressure, stable systolic parameters were observed in the postoperative period against the background of antihypertensive therapy taken before the operation.Conclusion. Carotid endarterectomy in the acute period of ischemic stroke is safe in the presence of mild neurological deficits (up to 25 points on the National Institute of Health Stroke Scale) and the diameter of the ischemic focus in the brain not exceeding 2.5 cm according to the computer data. tomography. Glomussparing ICA autotransplantation, developed on the basis of the Aleksandrovskaya Hospital, St. Petersburg, does not require the use of a patch and is not characterized by the risk of developing ICA thrombosis as a result of intimal detachment behind the endarterectomy zone. Preservation of the carotid glomus during reconstructive intervention on the ICA prevents the development of labile arterial hypertension and hemorrhagic transformation in the postoperative period.

Abstract 144: A Novel Multi-function Small Molecule for the Treatment of Acute Ischemic Stroke in Rodent and Non-human Primate

Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Sheng Wen Yeh ◽  
Yinghua Jiang ◽  
Tzulin Yeh ◽  
Wendy Chern
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Small Molecule ◽  
Brain Infarction ◽  
Radical Scavenging ◽  
Cynomolgus Macaque ◽  
Stroke Onset ◽  
Stroke Model ◽  
Thromboembolic Stroke

Background and rationale: DC007 is a synthetic small molecule with multiple pharmacological activities. It has been shown to have thrombolytic, anti-platelet and free radical scavenging activities in vitro. To explore its potential in treating acute ischemic stroke, we evaluated its safety and efficacy using a thromboembolic stroke model in rattus and in Cynomolgus macaque. Methods: Effects of DC007 (10mg/kg) were compared to intravenous tPA (10mg/kg in rat; 0.9mg/kg in monkey) using a model of focal embolic cerebral ischemia in rats and monkeys. Pre-formed blood clots were introduced into middle cerebral artery through catheter cannulated into internal carotid artery of the animals. Animals (12 rats per group; 4 monkeys per group) were randomized to receive intravenous infusion of saline, tPA or DC007 at 3 hours after embolization was confirmed. Results: DC007 reduced brain infarction and hemispheric swelling in the stroke rats more significantly than saline or tPA did, when treatments were given at 3 hours after stroke onset. At 24 hours after stroke, infraction volumes were 49.36%, 31.98%, and 40.66% for saline, DC007 and tPA group, respectively; while brain swelling rates were 17.67%, 13.20% and 22.58% for saline, DC007 and tPA group, respectively. In the thromboembolic stroke model in monkey, DC007 also showed a stronger beneficial effect on vessel patency (DC007: 46.3±10.3% vs. tPA: 22.2±12.8% in the 8 hours time period after stroke), brain infarction (DC007: 3361±354 mm 3 vs. tPA: 9072±2096 mm 3 measured by MRI at 24 hours after stroke) and neurobehavioral score measured at 72 hours after stroke (DC007: 46.3±10.3 vs. tPA: 60±9.8, where score 0 indicated normal, while score 77 indicated death). Conclusions: DC007 appears to be a more potent thrombolytic compound with superior safety profile than IV rt-PA when given at 3 hours after the stroke onset in rats and monkeys. Further investigation is warranted for its potential in the treatment of AIS clinically.

scholarly journals Left Common Carotid Artery Agenesis with Hypoplastic Left Internal Carotid Artery Originating from the Aortic Arch: A Rare Anomaly Presenting with Internal Carotid Artery Aneurysm and Subarachnoid Hemorrhage

2017 ◽  
Vol 01 (01) ◽  
pp. 049-052 ◽  
Author(s):  
Mandeep Ghuman ◽  
Vivek Gupta ◽  
Shankhneel Singh ◽  
S. Dhandapani ◽  
N. Khandelwal
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Common Carotid Artery ◽  
Internal Carotid ◽  
Left Common Carotid Artery ◽  
Vascular Pathology ◽  
External Carotid ◽  
Left Internal Carotid Artery ◽  
Radiographic Appearance

AbstractMost arch anomalies are asymptomatic and detected incidentally on imaging or on autopsy. Occasionally, such anomalies can manifest clinically when associated with another vascular pathology such as an intracranial aneurysm. In this report, we describe a rare case of agenesis of the left common carotid artery with separate origin of the left internal carotid artery and the external carotid artery from the arch discovered on digital subtraction angiography performed during the evaluation of subarachnoid hemorrhage. Knowledge of such anomalies and radiographic appearance is essential for interventional neuroradiologist in planning treatment of such cases.

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