A111 Development of a preclinical model of intracerebral intraparenchymal hematoma and strategies to limit its expansion

Résumé fourni par la source

Background/Introduction Very little progress has been made in the management of patients with cerebral hemorrhage. Early studies support the hypothesis that bleeding from the rupture of a primary vessel exerts shear forces on adjacent vessels, leading to further bleeding and hematoma expansion. Previous attempts to target hemorrhage expansion have failed to demonstrate improvements in clinical outcomes. The TIPITCH consortium (Transforming the Prognosis of IntraCerebral Hemorrhage) aims to develop innovative treatment strategies to address this unmet clinical need. Endovascular approaches to intracerebral hemorrhage (ICH) represent a promising emerging avenue for limiting hemorrhage expansion. Objective/Purpose The objective of our work is to develop a preclinical model of deep cerebral hematoma in rabbit, allowing navigation within its intracranial arteries. This model will enable close monitoring of hematoma progression and provide a platform to demonstrate that early, selective reduction of blood flow can slow hematoma growth. Methods/Case Description Intracerebral hemorrhage was induced by stereotactic collagenase injection targeting the basal ganglia via burr hole. Hematoma evolution was monitored using multimodal imaging, including cone-beam CT, ultrasound, angiography, post-mortem MRI, and histology. Hematoma growth was assessed by ultrasound every 15 minutes for 4 hours. We assessed whether early selective modulation of distal internal carotid artery and M1 middle cerebral artery flow could reduce hematoma expansion. Animals were randomized into Control or Experimental groups. The Experimental group underwent endovascular intervention 30 minutes after induction, consisting of 30-minute temporary flow occlusion. Results/Findings Reproducible hematoma formation was achieved. Ultrasound enabled longitudinal volumetric follow-up. Inclusion is ongoing; preliminary mixed-model analysis shows no significant difference, but a trend toward reduced hematoma volume after 120 min in Group Occlusion (group 1) Discussion/Conclusions/Learning Points If the proof of concept is confirmed, this approach could represent a game changer for the early management of ICH. Design of a novel endovascular device specifically dedicated to selective blood flow modulation to limit hemorrhage expansion.

Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.