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Alex Berenstein

-Balloon Catheter Technique The embolization microballoon catheter is injected coaxially through an introducer or outer catheter of No. 5.8 or 6.4 French thin-wall polyethylene, † which has been placed in the desired internal carotid artery (ICA) ( Fig. 2 ). The microballoon usually flows into the middle cerebral artery (MCA). A preliminary occlusive test of the middle cerebral trunk is performed to insure tolerance to MCA occlusion ( Fig. 3 ). A control ICA angiogram can be useful to demonstrate anterior cerebral collateral vessels supplying the temporarily occluded MCA

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Christopher M. Loftus, Julius A. Silvidi, Daniel D. Bernstein, Patrick W. Hitchon and Todd Rosier

occlusion and high-grade ischemia in the cat — effects of hemodilution. Stroke 17 : 37 – 43 , 1986 Coyer PE, Lesnick JE, Michele JJ, et al: Failure of the somatosensory evoked potential following middle cerebral artery occlusion and high-grade ischemia in the cat — effects of hemodilution. Stroke 17: 37–43, 1986 10. Coyle P , Heistad DD : Blood flow through cerebral collateral vessels in hypertensive and normotensive rats. Hypertension 8 (Suppl 2) : II:67 – II:71 , 1986 Coyle P, Heistad DD: Blood flow

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Temporary vessel occlusion in spontaneously hypertensive and normotensive rats

Effect of single and multiple episodes on tissue metabolism and volume of infarction

Warren R. Selman, Sana U. Bhatti, C. Cory Rosenstein, W. David Lust and Robert A. Ratcheson

cerebral infarction in spontaneously hypertensive (SHR) and normotensive Sprague-Dawley rats. Stroke 17: 520–525, 1986 9. Coyle P , Heistad DD : Blood flow through cerebral collateral vessels in hypertensive and normotensive rats. Hypertension 8 ( Suppl II ): II67 – II71 , 1986 Coyle P, Heistad DD: Blood flow through cerebral collateral vessels in hypertensive and normotensive rats. Hypertension 8 (Suppl II): II67–II71, 1986 10. Coyle P , Heistad DD : Blood flow through cerebral collateral vessels

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Patricia Fogarty-Mack, John Pile-Spellman, Lotfi Hacein-Bey, Noeleen Ostapkovich, Shailendra Joshi, Yvonne Vulliemoz and William L. Young

in the management of vasospasm complicating arteriovenous malformation resection. Report of two cases. J Neurosurg 82 : 296 – 299 , 1995 Morgan MK, Day MJ, Little N, et al: The use of intraarterial papaverine in the management of vasospasm complicating arteriovenous malformation resection. Report of two cases. J Neurosurg 82: 296–299, 1995 27. Muhonen MG , Loftus CM , Heistad DD : Effects of adenosine and 2-chloroadenosine on cerebral collateral vessels. J Cereb Blood Flow Metab 15 : 1075 – 1081 , 1995

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Michael G. Muhonen, Scott C. Robertson, Jeffrey S. Gerdes and Christopher M. Loftus

shown that 5-HT constricts large arteries and dilates small vessels. 8, 13, 37, 39, 42 Serotonin may play a role in reducing CBF to regions affected by vascular occlusion or hemorrhage. The reduced blood flow may lead to the formation of a thrombus during hemorrhage and/or redirect blood from the injured area to optimize overall circulation. Little is known about the effects of 5-HT on collateral CBF. We used a technique that separates normal and collateral-dependent CBF to test the hypothesis that cerebral collateral vessels constrict during infusion of 5-HT. 28

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Scott C. Robertson, Nicholas M. Wetjen, Bradley J. Beer and Christopher M. Loftus

test the hypothesis that blood flow in cerebral collateral vessels increased to ischemic areas after MK-801 administration. We used a technique that separates normal and collateral blood supply—dependent CBF. 27, 32–36, 41 The use of this technique allowed evaluation of the effects of MK-801 on collateral and normal cerebral vessels. We speculated that if MK-801 did not affect collateral vessels, then blood flow would increase to collateral blood supply—dependent tissue (CDT), whereas flow to the normal cerebrum would be decreased as a result of small vessel

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Helene Benveniste, Katie R. Kim, Laurence W. Hedlund, John W. Kim and Allan H. Friedman

7. Coyle P , Heistad DD : Blood flow through cerebral collateral vessels in hypertensive and normotensive rats. Hypertension 8 : II67 – II71 , 1986 Coyle P, Heistad DD: Blood flow through cerebral collateral vessels in hypertensive and normotensive rats. Hypertension 8: II67–II71, 1986 8. Coyle P , Odenheimer DJ , Sing CF : Cerebral infarction after middle cerebral artery occlusion in progenies of spontaneously stroke-prone and normal rats. Stroke 15 : 711 – 716 , 1984 Coyle P, Odenheimer DJ, Sing CF: Cerebral infarction after middle

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Torstein R. Meling, Angelika Sorteberg, Søren J. Bakke, Haldor Slettebø, Juha Hernesniemi and Wilhelm Sorteberg

; another patient only had double filling of the ACAs on the digital compression series and very little cross-flow to the contralateral MCA. In 3 patients the ipsilateral PCoA was not visualized, and in 1 patient it was only visible on the digital compression series. Another 4 patients had slim ipsilateral PCoAs. TABLE 3 Results of preoperative evaluation of cerebral collateral vessels * Tolerance to Acute Closure † Case No. Evaluation ACoA Ipsilat PCoA Angio TCD 1 not performed good caliber not visible

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Koji Kamijo and Toru Matsui

hours of an SAH leads to a very poor outcome, even in patients with adequate collateral capacity according to preoperative angiography. This phenomenon may be led by vasospasm-induced compromise of the cerebral collateral vessels. Based on these observations, Meling et al. have postulated that a high-flow EC-IC bypass before the onset of vasospasm would prevent vasospasm-induced cerebral infarcts and subsequent death associated with ICA sacrifice in the acute SAH period. We trapped aneurysms on the ICA and performed concomitant bypass surgery based on this theory. A