1.Anterior Choroidal Artery Aneurysms: Influence of Regional Microsurgical Anatomy on Safety of Endovascular Treatment.
Michael George Zaki GHALI ; Visish M SRINIVASAN ; Kathryn M WAGNER ; Sandi LAM ; Jeremiah N JOHNSON ; Peter KAN
Journal of Cerebrovascular and Endovascular Neurosurgery 2018;20(1):47-52
Several anatomical variables critically influence therapeutic strategizing for anterior choroidal artery (AChA) aneurysms, and specifically, the safety of flow diversion for these lesions. We review the microsurgical anatomy of the AChA, discussing and detailing these considerations in the treatment of AChA aneurysms, theoretically and in the light of our recent findings.
Aneurysm*
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Arteries*
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Choroid*
2.Canine Model for Selective and Superselective Cerebral Intra-Arterial Therapy Testing
Kevin M. CAMSTRA ; Visish M. SRINIVASAN ; Dalis COLLINS ; Stephen CHEN ; Peter KAN ; Jeremiah JOHNSON
Neurointervention 2020;15(3):107-116
Purpose:
With advancing endovascular technology and increasing interest in minimally invasive intra-arterial therapies such as stem cell and chemotherapy for cerebral disease, the establishment of a translational model with cerebral circulation accessible to microcatheters is needed. We report our experience catheterizing canine cerebral circulation with microcatheters, present high-resolution angiographic images of the canine vascular anatomy, describe arterial branch flow patterns and provide measurements of canine arterial conduits.
Materials and Methods:
Angiograms were performed on 10 intact purpose-bred hounds. Angiography, measurements of arterial conduits and catheterization information for intracranial arterial branches were obtained.
Results:
Selective and superselective cerebral angiography was successful in all subjects. Relevant arterial mean diameters include the femoral (4.64 mm), aorta (9.38 mm), external carotid (3.65 mm), internal carotid arteries (1.6 mm), vertebrobasilar system and Circle of Willis branches. Catheterization of the Circle of Willis was achieved via the posterior circulation in all subjects tested (n=3) and the use of flow directed microcatheters resulted in reduced arterial tree deformation and improved superselection of intracranial vessels. Catheterization of the intracranial circulation was attempted but not achieved via the internal carotid artery (n=7) due to its tortuosity and subsequent catheter related vasospasm.
Conclusion
The canine cerebral vasculature is posterior circulation dominant. Anterior circulation angiography is achievable via the internal carotid artery, but direct cerebral arterial access is best achieved via the posterior circulation using flow-directed microcatheters. It is feasible to deliver intra-arterial therapies to selective vascular territories within the canine cerebral circulation, thus making it a viable animal model for testing novel intra-arterial cerebral treatments.