Title

A canine model of mechanical thrombectomy in stroke

UMMS Affiliation

New England Center for Stroke Research, Department of Radiology

Publication Date

2019-05-18

Document Type

Article

Disciplines

Animal Experimentation and Research | Cardiovascular Diseases | Cardiovascular System | Nervous System Diseases | Radiology | Surgery | Surgical Procedures, Operative | Veterinary Medicine

Abstract

PURPOSE: To develop a preclinical model of stroke with a large vessel occlusion treated with mechanical thrombectomy.

MATERIALS AND METHODS: An ischemic stroke model was created in dogs by the introduction of an autologous clot into the middle cerebral artery (MCA). A microcatheter was navigated to the clot and a stent retriever thrombectomy was performed with the goal to achieve Thrombolysis in Cerebral Ischemia (TICI) 2b/3 reperfusion. Perfusion and diffusion MRI was acquired after clot placement and following thrombectomy to monitor the progression of restricted diffusion as well as changes in ischemia as a result of mechanical thrombectomy. Post-mortem histology was done to confirm MCA territory infarct volume.

RESULTS: Initial MCA occlusion with TICI 0 flow was documented in all six hound-cross dogs entered into the study. TICI 2b/3 revascularization was achieved with one thrombectomy pass in four of six animals (67%). Intra-procedural events including clot autolysis leading to spontaneous revascularization (n=1) and unresolved vasospasm (n=1) accounted for thrombectomy failure. In one case, iatrogenic trauma during microcatheter navigation resulted in a direct arteriovenous fistula at the level of the cavernous carotid. Analysis of MRI indicated that a volume of tissue from the initial perfusion deficit was spared with reperfusion following thrombectomy, and there was also a volume of tissue that infarcted between MRI and ultimate recanalization.

CONCLUSION: We describe a large animal stroke model in which mechanical thrombectomy can be performed. This model may facilitate, in a preclinical setting, optimization of complex multimodal stroke treatment paradigms for clinical translation.

Keywords

intervention, stroke, thrombectomy

DOI of Published Version

10.1136/neurintsurg-2019-014969

Source

J Neurointerv Surg. 2019 May 18. pii: neurintsurg-2019-014969. doi: 10.1136/neurintsurg-2019-014969. [Epub ahead of print] Link to article on publisher's site

Journal/Book/Conference Title

Journal of neurointerventional surgery

Related Resources

Link to Article in PubMed

PubMed ID

31103992

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