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Augmenting Regional Cerebral Blood Flow Using External-to-Internal Carotid Artery Flow Diversion Method

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Abstract

The objective of this study was to assess the effect of flow diversion by external carotid artery (ECA) occlusion on ipsilateral regional cerebral blood flow (rCBF). Local cerebral hyperperfusion in rats (n = 12) was induced by ligating the right ECA. Ipsilateral rCBF was determined pre- and post-ligation for 120 min using a laser Doppler flow meter. Sham animals (n = 6) were subjected to the craniotomy without ligation of the right ECA. In a separate series of rats (n = 5), brain tissue oxygen levels (pO2) in the right and left brain hemispheres were determined before and 90 min after ligation of the right ECA using a tissue oxygenation monitoring unit. We investigated the effect of ECA occlusion hemispheric changes in rCBF in one clinical case as a proof of concept. Ligation of ECA resulted in a statistically significant increase in rCBF on the ipsilateral side compared to the sham-operated rats (p < 0.0001). On average we observed a 34% increase (95% CI: 24–45%) in rCBF in the ipsilateral territory in the treated group compared with sham-operated rats. There was no significant variation in MAP for the treated animals. Vascular permeability and cerebral water content in the right hemisphere after ligation of ECA did not significantly differ from the contralateral hemisphere. Ipsilateral hemisphere tissue pO2 was significantly higher compared to the contralateral area (p < 0.002) post-ligation or to the ipsilateral area (p < 0.001) prior to ligation. In the clinical case, occlusion of ECA resulted in 3.6% and 12.1% increase in peak value and rise-time of the time-density curves. Flow diversion by temporary occlusion of the ECA can result in increased rCBF and cerebral pO2 on the ipsilateral side. The strategy may represent a viable option to augment rCBF in focal cerebral ischemia.

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Authors and Affiliations

  1. Zeenat Qureshi Stroke Research Center and Minnesota Stroke Initiative, Department of Neurology, University of Minnesota, MMC 295, 420 Delaware Street S.E., Minneapolis, MN, 55455, USA

    Afshin A. Divani, Gabriela Vazquez, Ramachandra Tummala & Adnan I. Qureshi

  2. Zeenat Qureshi Stroke Research Center and Minnesota Stroke Initiative, Department of Neurosurgery, University of Minnesota, Minneapolis, MN, USA

    Afshin A. Divani, Ramachandra Tummala & Adnan I. Qureshi

  3. Zeenat Qureshi Stroke Research Center and Minnesota Stroke Initiative, Department of Radiology, University of Minnesota, Minneapolis, MN, USA

    Afshin A. Divani, Ramachandra Tummala & Adnan I. Qureshi

  4. Department of Neurology and Neurosciences, University of Medicine and Dentistry of New Jersey, Newark, NJ, USA

    Tamara L. Berezina & Sergey B. Zaets

Authors
  1. Afshin A. Divani
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  2. Tamara L. Berezina
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  3. Gabriela Vazquez
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  4. Sergey B. Zaets
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  5. Ramachandra Tummala
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  6. Adnan I. Qureshi
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Correspondence to Afshin A. Divani.

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Divani, A.A., Berezina, T.L., Vazquez, G. et al. Augmenting Regional Cerebral Blood Flow Using External-to-Internal Carotid Artery Flow Diversion Method. Ann Biomed Eng 37, 2428–2435 (2009). https://doi.org/10.1007/s10439-009-9782-2

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  • DOI: https://doi.org/10.1007/s10439-009-9782-2

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