Doccol Made a Difference in Stroke Modeling

Doccol MCAO Sutures Reduce SD to 5% of Its Corresponding Mean Value for Infarction Volume

In the stroke model literature, two types of MCAO (middle cerebral artery occlusion) models are most frequently used, which are the Koizumi model (Koizumi et al. 1986), and the Longa model (Longa et al. 1989). The Koizumi model suggested the use of silicone rubber-coated monofilaments as occludors whilst the Longa model used flame-blunted monofilaments. It turned out that silicone rubber-coated monofilaments are superior to flame-blunted monofilaments for producing consistent ischemic brain injuries. A study (Tsuchiya et al. 2003) showed that using flame-blunted monofilaments for inducing MCA occlusion caused 40% occurrence of subarachnoid hemorrhage, and the standard deviation for infarction volume was greater than its corresponding mean value. Another technical paper specifically compared the effects of suture types on the infarct consistency and showed that silicone rubber-coated monofilaments were superior to flame-blunted ones, producing consistent infarction; and this was true even with inexperienced surgeons. (Shimamura et al. 2006a) In the mouse intraluminal model, SAH rate could reach 40% if uncoated heat-blunted monofilaments being used; and such a modeling method resulted in the deviation for infarction volume being larger than 50% of its corresponding mean value. (Tsuchiya et al. 2003) The poly-L-Lysine coated monofilament seemed could only increase the mortality (to a rate of 60%), without any benefits for reducing infarct variation. (Huang et al. 1998)

The mechanism behind the outcome variation is the frequent occurrence of insufficient occlusion, premature reperfusion, and filament dislodgement. Doccol MCAO sutures have a sufficient length of coated surface, which is cylindrical in shape, elastic, and smooth. Doccol MCAO sutures, with such a physical property and huge selections for different coating diameters and coating length, are able to reduce the occurrence of the insufficient occlusion, the premature reperfusion, and the monofilament dislodgement.

 

 The standard deviation for infarction volume, when home-made silicone rubber-coated monofilaments being used, is around 30% of its corresponding mean value both in rats (Schmid-Elsaesser et al. 1998) and in mice (Shah et al. 2006). The use of Doccol MCAO sutures has been reported to be able to achieve a much better result. For examples, a 15-min occlusion by using home-prepared monofilaments usually produces no apparent ischemic damage whilst a consistent caudate infarction can be achieved when Doccol MCAO sutures being used; (Pignataro et al. 2007a) The standard deviation for infarction volume is around 10% to 20% of its corresponding mean values for 60-min transient to 24-h permanent occlusions in rats, (Candelario-Jalil et al. 2008; Khan et al. 2006; Liu et al. 2006; Shimamura et al. 2006b; Solaroglu et al. 2006; Tsubokawa et al. 2007; Tsubokawa et al. 2006a; Tsubokawa et al. 2006b) and around 5-10% of its corresponding mean value for the 60-min occlusion in mice, (Kleinschnitz et al. 2007; Maysami et al. 2008; Pignataro et al. 2007b; Pignataro et al. 2007c) when Doccol MCAO sutures being used. Some variation in infarct volumes may be contributed by the differences of experimental design and the selection of the right-sized monofilaments.

References

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