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Microvascular Embolism Mouse Model for In Vivo Two-photon Microscopy Using Fluorescent Polystyrene Microspheres

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Post-interventional microembolism: cortical border zone is a preferential site for ischemia.

Kwang-Yeol Park¹, Pil-Wook Chung, Yong Bum Kim

¹Department of Neurology, Chung-Ang University Medical Center, Chung-Ang University College of Medicine, Seoul, South Korea.

Cerebrovascular Diseases (Basel, Switzerland)

|September 7, 2011

Summary

Silent embolisms after neurointerventional procedures commonly affect the cerebral cortical border zone and cerebellum. Microembolisms rarely impact deep perforating artery territories, according to diffusion-weighted MRI findings.

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Photothrombotic Ischemia: A Minimally Invasive and Reproducible Photochemical Cortical Lesion Model for Mouse Stroke Studies

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Published on: June 9, 2013

Area of Science:

Neuroimaging and Interventional Neurology
Cerebrovascular Diseases
Radiology

Background:

Silent embolism is a known complication of neurointerventional procedures, occurring in 10-40% of patients.
Previous studies using diffusion-weighted MRI (DWI) have identified these embolisms, but their specific lesion patterns remain under-investigated.

Purpose of the Study:

To investigate the lesion patterns of silent embolisms following cerebral angioplasty and stent procedures.
To classify and analyze the distribution of new DWI lesions in non-treated arterial territories.

Main Methods:

Diffusion-weighted MRI (DWI) was performed within 7 days before and 48 hours after neurointerventional procedures.
New DWI lesions were analyzed and classified based on arterial territories: supratentorial (cortical and subcortical) and infratentorial (brainstem and cerebellar).
Cortical lesions were further categorized into cortical border zone and cortical proper; subcortical lesions into deep perforator and internal border zone.

Main Results:

Out of 72 patients, 37 had 223 new DWI lesions in non-treated territories.
The majority of lesions were cortical (154), predominantly in the cortical border zone (88/154).
Infratentorial lesions were mainly in the cerebellar hemisphere (45/48), while deep perforator territory lesions were rare (4/223).

Conclusions:

Interventional angiography-related microembolisms predominantly localize to the cerebral cortical border zone and cerebellar hemisphere.
Microembolisms affecting the deep perforating artery territory are infrequent.
DWI is crucial for characterizing the patterns and locations of silent embolisms post-neurointervention.