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Infarct Evolution in a Large Animal Model of Middle Cerebral Artery Occlusion

  • Mohammed Salman ShazeebEmail author
  • Robert M. King
  • Olivia W. Brooks
  • Ajit S. Puri
  • Nils Henninger
  • Johannes Boltze
  • Matthew J. Gounis
Original Article
  • 92 Downloads

Abstract

Mechanical thrombectomy for the treatment of ischemic stroke shows high rates of recanalization; however, some patients still have a poor clinical outcome. A proposed reason for this relates to the fact that the ischemic infarct growth differs significantly between patients. While some patients demonstrate rapid evolution of their infarct core (fast evolvers), others have substantial potentially salvageable penumbral tissue even hours after initial vessel occlusion (slow evolvers). We show that the dog middle cerebral artery occlusion model recapitulates this key aspect of human stroke rendering it a highly desirable model to develop novel multimodal treatments to improve clinical outcomes. Moreover, this model is well suited to develop novel image analysis techniques that allow for improved lesion evolution prediction; we provide proof-of-concept that MRI perfusion-based time-to-peak maps can be utilized to predict the rate of infarct growth as validated by apparent diffusion coefficient-derived lesion maps allowing reliable classification of dogs into fast versus slow evolvers enabling more robust study design for interventional research.

Keywords

Dog Middle cerebral artery occlusion Infarct growth rate Perfusion MRI Time-to-peak Stroke 

Notes

Authors’ Contributions

The concept of study was developed by Matthew Gounis, Nils Henninger, Johannes Boltze, and Ajit Puri. Robert King and Matthew Gounis performed the animal experiments and collected the imaging data. Olivia Brooks performed data analysis. Mohammed Salman Shazeeb developed the image analysis pipeline, performed image analysis, and wrote the manuscript. Robert King also performed image analysis. Mathew Gounis, Nils Henninger, Johannes Boltze, and Robert King made significant edits to the manuscript for intellectual content. All authors read and approved the final manuscript.

Funding Information

Dr. Henninger is supported by K08NS091499 from the National Institute of Neurological Disorders and Stroke (NINDS) of the National Institutes of Health (NIH). The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH. Dr. Gounis has received research support from the NIH, the United States–Israel Binational Science Foundation, Anaconda, Cerenovus, Ceretrieve, Cook Medical, Gentuity, Imperative Care, InNeuroCo, Magneto, Microvention, Medtronic Neurovascular, MIVI Neurosciences, Neuravi, Neurogami, Philips Healthcare, Rapid Medical, Route 92 Medical, Stryker Neurovascular, Syntheon, and the Wyss Institute.

Compliance with Ethical Standards

Conflict of Interest

Dr. Henninger is supported by K08NS091499 from the National Institute of Neurological Disorders and Stroke of the National Institutes of Health (NIH). The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH. Dr. Henninger serves on the advisory board of Omniox, Inc. and serves as consultant to Astrocyte Pharmaceuticals, Inc. Dr. Gounis has been a consultant on a fee-per-hour basis for Cerenovus, Imperative Care, Mivi Neurosciences, Phenox, Route 92 Medical, Stryker Neurovascular; holds stock in Imperative Care and Neurogami; and has received research support from the NIH, the United States–Israel Binational Science Foundation, Anaconda, Cerenovus, Ceretrieve, Cook Medical, Gentuity, Imperative Care, InNeuroCo, Magneto, Microvention, Medtronic Neurovascular, MIVI Neurosciences, Neuravi, Neurogami, Philips Healthcare, Rapid Medical, Route 92 Medical, Stryker Neurovascular, Syntheon, and the Wyss Institute. All authors declare that they have no potential conflicts of interest in regard to the research, authorship, and publication of this paper.

Ethical Approval

All animal research procedures were performed as approved by the Institutional Animal Care and Use Committee (IACUC) of the University of Massachusetts Medical School (Worcester, MA, USA). This article does not contain any studies with human participants performed by any of the authors.

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.New England Center for Stroke Research, Department of RadiologyUniversity of Massachusetts Medical SchoolWorcesterUSA
  2. 2.Image Processing and Analysis Core, Department of RadiologyUniversity of Massachusetts Medical SchoolWorcesterUSA
  3. 3.Department of Biomedical EngineeringWorcester Polytechnic InstituteWorcesterUSA
  4. 4.St. George’s University School of MedicineSt. George’sGrenada
  5. 5.Department of NeurologyUniversity of Massachusetts Medical SchoolWorcesterUSA
  6. 6.Department of PsychiatryUniversity of Massachusetts Medical SchoolWorcesterUSA
  7. 7.School of Life SciencesUniversity of WarwickCoventryUK

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