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Endovascular middle cerebral artery embolic stroke model: a novel approach
  1. L Fernando Gonzalez1,
  2. David S Warner2,
  3. Huaxing Sheng1,
  4. Eduardo Chaparro1
  1. 1Neurosurgery, Duke University Hospital, Durham, North Carolina, USA
  2. 2Department of Anesthesia, Duke University, Durham, North Carolina, USA
  1. Correspondence to Dr L Fernando Gonzalez, Neurosurgery, Duke University Hospital, Durham, North Carolina 27710, USA; fernando.gonzalez{at}duke.edu

Abstract

A video (video 1) describing a novel murine endovascular embolic stroke model is presented. Traditional middle cerebral artery (MCA) occlusion models include a blind insertion of a monofilament string1,2 into the common or external carotid artery with the expectation to selectively occlude the MCA. However, significant mortality occurs due to subarachnoid hemorrhage and variability in stroke size, possibly related to the filament’s malposition—for example, external carotid or proximal internal carotid artery (ICA). Additionally, while the string is in place, it occludes the entire extracranial ICA affecting also the collateral pial circulation.

Video 1

Our model includes tail artery access, which tolerates several procedures facilitating survival studies. This model uses autologous blood3 4 clot deployed directly into the MCA, resembling what occurs in clinical practice. Autologous thrombi could be lysed with IA/IV tissue plasminogen activator.

In summary, we describe a novel model that resembles real practice, permits multiple catheterizations, results in reliable embolization under fluoroscopic guidance and allows therapeutic interventions not available with traditional models.

  • embolic
  • stroke model
  • brain
  • angiography
  • endovascular

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Footnotes

  • Twitter @fegomd

  • Contributors EC provided anesthesia, assisted during the procedure, autopsy and histology. HS assisted during the surgical arterial cut down procedure. LFG, tail artery canulation, performed angiographic procedures. DSW, assisted during the sttudy design interpretation.

  • Funding Internal funding, Department of Neurosurgery.

  • Disclaimer Duke University IACUC and Infectious Disease Committee approval

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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