Cerebral collateral therapeutics in acute ischemic stroke: A randomized preclinical trial of four modulation strategies

Cerebral collaterals are dynamically recruited after arterial occlusion and highly affect tissue outcome in acute ischemic stroke. We investigated the efficacy and safety of four pathophysiologically distinct strategies for acute modulation of collateral flow (collateral therapeutics) in the rat str...

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Published in:Journal of cerebral blood flow and metabolism 2017-10, Vol.37 (10), p.3344-3354
Main Authors: Beretta, Simone, Versace, Alessandro, Carone, Davide, Riva, Matteo, Dell’Era, Valentina, Cuccione, Elisa, Cai, Ruiyao, Monza, Laura, Pirovano, Silvia, Padovano, Giada, Stiro, Fabio, Presotto, Luca, Paternò, Giovanni, Rossi, Emanuela, Giussani, Carlo, Sganzerla, Erik P, Ferrarese, Carlo
Format: Article
Language:English
Subjects:
Animals
Brain Ischemia - therapy
Cerebrovascular Circulation
Collateral Circulation - drug effects
Head-Down Tilt - physiology
Infarction, Middle Cerebral Artery
Original
Perfusion
Rats
Stroke - therapy
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Summary:Cerebral collaterals are dynamically recruited after arterial occlusion and highly affect tissue outcome in acute ischemic stroke. We investigated the efficacy and safety of four pathophysiologically distinct strategies for acute modulation of collateral flow (collateral therapeutics) in the rat stroke model of transient middle cerebral artery (MCA) occlusion. A composed randomization design was used to assign rats (n = 118) to receive phenylephrine (induced hypertension), polygeline (intravascular volume load), acetazolamide (cerebral arteriolar vasodilation), head down tilt (HDT) 15° (cerebral blood flow diversion), or no treatment, starting 30 min after MCA occlusion. Compared to untreated animals, treatment with collateral therapeutics was associated with lower infarct volumes (62% relative mean difference; 51.57 mm3 absolute mean difference; p 
ISSN:0271-678X
1559-7016
DOI:10.1177/0271678X16688705