Hyperperfusion profiles after recanalization differentially associate with outcomes in a rat ischemic stroke model

Bart A.A. Franx*, Geralda A.F. van Tilborg, Aladdin Taha, Joaquim Bobi, Annette van der Toorn, Caroline L. Van Heijningen, Heleen M.M. van Beusekom, Ona Wu, Rick M. Dijkhuizen*

*Corresponding author for this work

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3 Citations (Scopus)
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Futile recanalization hampers prognoses of ischemic stroke after successful mechanical thrombectomy, hypothetically through post-recanalization perfusion deficits, onset-to-groin delays and sex effects. Clinically, acute multiparametric imaging studies remain challenging. We assessed possible relationships between these factors and disease outcome after experimental cerebral ischemia-reperfusion, using translational MRI, behavioral testing and multi-model inference analyses. Male and female rats (N = 60) were subjected to 45-/90-min filament-induced transient middle cerebral artery occlusion. Diffusion, T2- and perfusion-weighted MRI at occlusion, 0.5 h and four days after recanalization, enabled tracking of tissue fate, and relative regional cerebral blood flow (rrCBF) and -volume (rrCBV). Lesion areas were parcellated into core, salvageable tissue and delayed injury, verified by histology. Recanalization resulted in acute-to-subacute lesion volume reductions, most apparently in females (n = 19). Hyperacute normo-to-hyperperfusion in the post-ischemic lesion augmented towards day four, particularly in males (n = 23). Tissue suffering delayed injury contained higher ratios of hypoperfused voxels early after recanalization. Regressed against acute-to-subacute lesion volume change, increased rrCBF associated with lesion growth, but increased rrCBV with lesion reduction. Similar relationships were detected for behavioral outcome. Post-ischemic hyperperfusion may develop differentially in males and females, and can be beneficial or detrimental to disease outcome, depending on which perfusion parameter is used as explanatory variable.

Original languageEnglish
Pages (from-to)209-223
Number of pages15
JournalJournal of Cerebral Blood Flow and Metabolism
Issue number2
Early online date24 Oct 2023
Publication statusPublished - Feb 2024

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