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Original Research ARTICLE Provisionally accepted The full-text will be published soon. Notify me

Front. Neurol. | doi: 10.3389/fneur.2019.01113

Development of a routinely applicable imaging protocol for fast and precise middle cerebral artery occlusion assessment and perfusion deficit measure in an ovine stroke model: a case study

Giorgio Cattaneo1,  Andrea M. Herrmann2, 3, Sebastian A. Eiden3, Manuela Wieser3, Elias Kellner4,  Christoph Maurer5,  Jörg Haberstroh6,  Wolf-Dirk Niesen7, Horst Urbach3,  Johannes Boltze8, 9,  Stephan Meckel3* and  Mukesch Shah10
  • 1Other, Germany
  • 2Institute of Veterinary Anatomy, Histology and Embryology, Faculty of Veterinary Medicine, University of Leipzig, Germany
  • 3Department of Neuroradiology, University Hospital Freiburg, Germany
  • 4Department of Radiology and Medical Physics, University Hospital Freiburg, Germany
  • 5Department for Diagnostic and Interventional Radiology and Neuroradiology, Augsburg University Hospital, Germany
  • 6Center for Experimental Models and Transgenic Service, University Hospital Freiburg, Germany
  • 7Department of Neurology, University of Freiburg, Germany
  • 8Institute of Medical and Marine Biotechnology, University of Lübeck, Germany
  • 9School of Life Sciences, Faculty of Science, University of Warwick, United Kingdom
  • 10Department of Neurosurgery, University Hospital Freiburg, Germany

Temporary middle cerebral artery occlusion (MCAO) in sheep allows modelling 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 hours, 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.

Keywords: MCAO, sheep stroke model, Reperfusion, CT perfusion, DSA = digital subtraction angiography

Received: 11 Apr 2019; Accepted: 04 Oct 2019.

Copyright: © 2019 Cattaneo, Herrmann, Eiden, Wieser, Kellner, Maurer, Haberstroh, Niesen, Urbach, Boltze, Meckel and Shah. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Prof. Stephan Meckel, Department of Neuroradiology, University Hospital Freiburg, Freiburg, 79106, Germany, stephanmeckel@gmail.com