Herrmann Andrea Maria, Cattaneo Giorgio Franco Maria, Eiden Sebastian Alexander, Wieser Manuela, Kellner Elias, Maurer Christoph, Haberstroh Jörg, Mülling Christoph, Niesen Wolf-Dirk, Urbach Horst, Boltze Johannes, Meckel Stephan, Shah Mukesch Johannes
Department of Neuroradiology, Faculty of Medicine, Medical Center - University of Freiburg, University of Freiburg, Freiburg, Germany.
Faculty of Veterinary Medicine, Institute of Veterinary Anatomy, Histology and Embryology, Leipzig University, Leipzig, Germany.
Front Neurol. 2019 Nov 14;10:1113. doi: 10.3389/fneur.2019.01113. eCollection 2019.
Temporary middle cerebral artery occlusion (MCAO) in sheep allows modeling of acute large vessel occlusion stroke and subsequent vessel recanalization. However, rapid and precise imaging-based assessment of vessel occlusion and the resulting perfusion deficit during MCAO still represents an experimental challenge. Here, we tested feasibility and suitability of a strategy for MCAO verification and perfusion deficit assessment. We also compared the extent of the initial perfusion deficit and subsequent lesion size for different MCAO durations. The rete mirabile prevents reliable vascular imaging investigation of middle cerebral artery filling status. Hence, computed tomography perfusion imaging was chosen for indirect confirmation of MCAO. Follow-up infarct size evaluation by diffusion-weighted magnetic resonance imaging revealed fluctuating results, with no apparent relationship of lesion size with MCAO at occlusion times below 4 h, potentially related to the variable collateralization of the MCA territory. This underlines the need for intra-ischemic perfusion assessment and future studies focusing on the correlation between perfusion deficit, MCAO duration, and final infarct volume. Temporary MCAO and intra-ischemic perfusion imaging nevertheless has the potential to be applied for the simulation of novel recanalization therapies, particularly those that aim for a fast reperfusion effect in combination with mechanical thrombectomy in a clinically realistic scenario.
绵羊大脑中动脉临时闭塞（MCAO）可用于模拟急性大血管闭塞性中风及随后的血管再通。然而，在MCAO期间基于成像快速、精确地评估血管闭塞及由此产生的灌注缺损仍是一项实验挑战。在此，我们测试了一种MCAO验证及灌注缺损评估策略的可行性和适用性。我们还比较了不同MCAO持续时间下初始灌注缺损程度和后续梗死灶大小。奇网（rete mirabile）妨碍了对大脑中动脉充盈状态进行可靠的血管成像研究。因此，选择计算机断层扫描灌注成像来间接确认MCAO。通过扩散加权磁共振成像进行的随访梗死灶大小评估结果波动，在闭塞时间低于4小时时，梗死灶大小与MCAO无明显关联，这可能与MCA区域的可变侧支循环有关。这凸显了缺血期灌注评估的必要性以及未来专注于灌注缺损、MCAO持续时间和最终梗死体积之间相关性的研究。不过，临时MCAO和缺血期灌注成像仍有潜力应用于新型再通治疗的模拟，特别是那些旨在在临床实际场景中结合机械取栓实现快速再灌注效果的治疗。
