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    A thromboembolic model for the efficacy and safety evaluation of combined mechanical and pharmacologic revascularization strategies

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    Authors
    Gounis, Matthew J.
    Nogueira, Raul G.
    Mehra, Manik
    Chueh, Juyu
    Wakhloo, Ajay K.
    UMass Chan Affiliations
    Department of Radiology
    Document Type
    Journal Article
    Publication Date
    2013-05-01
    Keywords
    Cerebral Revascularization
    Cardiovascular Diseases
    Neurology
    Radiology
    Surgery
    Surgical Procedures, Operative
    
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    Link to Full Text
    http://dx.doi.org/10.1136/neurintsurg-2012-010435
    Abstract
    BACKGROUND AND PURPOSE: Recanalization strategies mediated by intra-arterial fibrinolytic therapy in combination with mechanical clot disruption may be a more effective treatment approach than either therapy used alone. There are few preclinical animal models to evaluate these strategies. Here we report on a model to simultaneously evaluate both of these treatment approaches. METHODS: Allogeneic clot was injected through the 6 F guide catheter after creating >50% luminal stenosis of the common carotid arteries of New Zealand White rabbits. The stenosis was released after 1 h, allowing sufficient time for clot-vessel wall interaction. Occlusion was confirmed and each vessel was assigned to receive either balloon angioplasty alone, intra-arterial tissue plasminogen activator (tPA, Alteplase, Genentech, San Francisco, California, USA), tPA delivery through prototype balloon infusion wire (NIT Therapeutics, Pittsburgh, Pennsylvania, USA), partial stent deployment or partial stent deployment with locally delivered tPA. The negative control received no treatment. RESULTS: In vivo revascularization Thrombolysis in Cerebral Infarction (TICI) score revealed that the balloon infusion wire achieved a stable and higher revascularization score of TICI 2B, with a lower dose of tPA in comparison with other treatment strategies. All treatment strategies resulted in endothelial denudation and exposure of the internal elastic lamina. CONCLUSIONS: The proposed animal model permits reliable and consistent thromboembolic occlusion of the target vasculature and allows for an assessment of both pharmacologic and mechanical revascularization strategies for acute ischemic stroke.
    Source
    J Neurointerv Surg. 2013 May;5 Suppl 1:i85-9. doi: 10.1136/neurintsurg-2012-010435. Link to article on publisher's site
    DOI
    10.1136/neurintsurg-2012-010435
    Permanent Link to this Item
    http://hdl.handle.net/20.500.14038/30266
    PubMed ID
    22962414
    Related Resources
    Link to Article in PubMed
    Rights
    This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 3.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/3.0/
    ae974a485f413a2113503eed53cd6c53
    10.1136/neurintsurg-2012-010435
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