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一种前循环大血管闭塞性卒中的犬类血栓栓塞模型。

A canine thromboembolic model of anterior circulation large vessel occlusion stroke.

作者信息

Zakeri Amanda S, Wheeler Debra G, Huttinger Allyson, Carfora Arianna, Kini Aarushi, Stork Taggart, Yacoub Simon, Anderson Cole, Joseph Matthew, Shujaat Mohammed T, Nimjee Shahid M

机构信息

Department of Neurosurgery, The Ohio State University Medical Center, Columbus, OH, USA.

Dorothy M. Davis Heart and Lung Research Institute, The Ohio State University Medical Center, Columbus, OH, USA.

出版信息

Heliyon. 2023 Apr 1;9(4):e14692. doi: 10.1016/j.heliyon.2023.e14692. eCollection 2023 Apr.

Abstract

PURPOSE

To develop a large animal preclinical model of thromboembolic stroke with stable, protracted large vessel occlusion (LVO) utilizing an autologous clot.

MATERIALS AND METHODS

A reproducible canine model of large vessel occlusion stroke was established by endovascular placement of an autologous clot into the middle cerebral artery (MCA) of six adult hounds and confirmed using digital subtraction angiography (DSA). Infarct volume and evidence of hemorrhage were determined by magnetic resonance imaging (MRI) 7 h after occlusion and Thrombolysis in Cerebral Infarction scale (TICI) was assessed before and after clot placement and at 1, 6, 7, and 9 h after middle cerebral artery occlusion (MCAO). Heart rate (HR) and blood pressure (BP) were monitored continuously and invasively through an arterial sheath throughout the procedures and complete blood count and blood gas analysis completed at time of sacrifice. Histopathological findings at time of sacrifice were used to confirm stroke volume and hemorrhage.

RESULTS

MCAO with resulting TICI 0 flow was observed in all six animals, verified by serial DSA, and lack of collateral flow persisted for 9 h after clot placement until time of sacrifice. The mean infarct volume was 47.0 ± 6.7% of the ipsilateral hemisphere and no events of spontaneous recanalization or clot autolysis were observed.

CONCLUSION

We demonstrate a thromboembolic canine model of MCAO that is both feasible and results in consistent infarct volumes to generate a clinically relevant LVO. This model is important to evaluate treatment of LVO in acute ischemic stroke (AIS) outside the established 4.5 h recombinant tissue plasminogen activator (rTPA) therapeutic window utilizing a prolonged occlusive thrombus.

摘要

目的

利用自体血凝块建立一种具有稳定、持久大血管闭塞(LVO)的血栓栓塞性中风大动物临床前模型。

材料与方法

通过血管内将自体血凝块置于6只成年猎犬的大脑中动脉(MCA)内,建立一种可重复的大血管闭塞性中风犬模型,并使用数字减影血管造影(DSA)进行确认。在闭塞后7小时通过磁共振成像(MRI)确定梗死体积和出血情况,并在血凝块放置前后以及大脑中动脉闭塞(MCAO)后1、6、7和9小时评估脑梗死溶栓量表(TICI)。在整个手术过程中通过动脉鞘连续有创监测心率(HR)和血压(BP),并在处死时完成全血细胞计数和血气分析。处死时的组织病理学结果用于确认中风体积和出血情况。

结果

所有6只动物均观察到导致TICI 0级血流的MCAO,经系列DSA证实,血凝块放置后9小时直至处死时均持续存在侧支血流缺乏。平均梗死体积为同侧半球的47.0±6.7%,未观察到自发再通或血凝块自溶事件。

结论

我们展示了一种可行的MCAO血栓栓塞性犬模型,其梗死体积一致,可产生临床相关的LVO。该模型对于评估在既定的4.5小时重组组织型纤溶酶原激活剂(rTPA)治疗窗之外利用延长的闭塞性血栓治疗急性缺血性中风(AIS)中的LVO很重要。

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