Partial Carotid Occlusion as Treatment for Intracranial Internal Carotid Aneurysms

A study was undertaken to investigate the possibility of using partial carotid occlusion instead of complete carotid ligation for the treatment of intracranial internal carotid aneurysms with a view to avoiding such complications of the latter procedure as neurological deficit resulting from cerebral ischemia, and ascending thrombus formation. The beneficial effect of carotid ligation has been explained by the interruption of pulsatile flow which can cause rupture of an aneurysm by resonance phenomena. Studies on blood flow in the aorta in dogs, as well as in a human carotid artery in vivo and in vitro, showed that the same object could be achieved by the use of constriction by a Poppen clamp. This changed the pulsatile blood flow to a relatively non-pulsatile state with slight diminution in mean flow. Partial occlusion of the common carotid artery is recommended for those cases of intracranial aneurysm in which complete carotid occlusion would not likely be tolerated.     

螺旋CT头颈部血管成像对急性脑梗死患者颈动脉狭窄的诊断价值

目的:探讨螺旋CT头颈部血管成像对急性脑梗死患者颈动脉狭窄的诊断价值。方法:选取2014年1月至2016年1月期间来我院就诊的60例急性脑梗死患者作为观察组,另选同期来我院就诊的非急性脑梗死患者60例作为对照组。两组患者均进行螺旋CT头颈部血管成像检查,比较两组患者的颈动脉狭窄程度及各段血管斑块分布情况,并根据检查结果评价螺旋CT头颈部血管成像对急性脑梗死患者颈动脉狭窄的诊断价值。结果:观察组轻度狭窄与中度狭窄检出率均显著高于对照组(P0.05),重度狭窄与闭塞检出率与对照组比较无统计学差异(P0.05),观察组总检出狭窄率高于对照组(P0.05)。观察组与对照组在颈动脉分叉处、颈总动脉、颈内动脉及颈外动脉均有斑块检出,观察组斑块总检出率为69.4%,显著高于对照组的41.2%(P0.05)。结论:临床上应用128层螺旋CT头颈部血管成像技术对急性脑梗死患者颈动脉狭窄情况可进行有效评估,该方法对患者轻、中度狭窄以及双侧颈动脉斑块检出率更高,在临床诊断及预后防治中具有应用推广价值。     

视网膜静脉阻塞与颈动脉狭窄的相关性研究

目的:探究视网膜静脉阻塞与颈动脉狭窄的相关性研究,并为其临床检测、治疗与预后提供参考。方法:选择我院55例视网膜静脉阻塞患者(55只眼)为研究组,对其裸眼视力、矫正视力、眼压、眼底血管荧光造影(FFA)等检查资料进行分析,并进行多普勒彩超检查,记录其颈动脉狭窄情况,并对两种疾病之间的关系进行分析。同时选取55例健康人作为对照组。结果:研究组55例患者确诊为视网膜静脉阻塞(RVO),多普勒结果显示患者患侧与健侧劲动脉血流动力学各项差异不明显(P0.05);其IMT值较之对照组显著增高(P0.05);其PSV与EDV值有所降低,差异具有统计学意义(P0.05)。结论:视网膜静脉阻塞患者大多存在颈动脉狭窄,因此检测颈动脉血流动力学对于诊断与预防视网膜静脉阻塞有着重要作用。     

凝闭双侧椎动脉预处理对大鼠全脑缺血损伤的防护作用

目的：观察凝闭双侧椎动脉与夹闭双侧颈总动脉之间的不同时间间隔对Pulsinelli四血管闭塞法全脑缺血模型的影响、以及在凝闭单侧椎动脉的基础上夹闭双侧颈总动脉后的脑缺血的特点。方法：84只Wistar大鼠．随机分为以下4组：对照组、双侧椎动脉凝闭组、全脑缺血组、单侧椎动脉凝闭＋双侧颈总动脉夹闭组。全脑缺血组中,根据凝闭双侧椎动脉与夹闭双侧颈总动脉之间的时间间隔不同,又分为24h间隔、48h间隔和72h间隔3个亚组。观察大鼠脑缺血过程中的反应包括瞳孔散大、对光反射等情况,脑缺血后恢复翻正反射所需要的时间、以及动物的一般状况,并应用硫堇染色法观察海马CA1区锥体神经元迟发性死亡的情况：结果：全脑缺血72h间隔亚组的大鼠,脑缺血过程中的反应、脑缺血后的一般状况和锥体神经元迟发性死亡程度均明显重于全脑缺血24h间隔亚组及48h间隔亚组,但24h间隔亚组与48h间隔亚组之间无显著差异一单侧椎动脉凝闭＋双侧颈总动脉夹闭组大鼠的凝闭侧瞳孔散大、对光反射消失、海马CA1区神经元大量死亡;而未凝闭侧未见上述相关变化。结论：凝闭双侧椎动脉本身也具有脑缺血预处理样作用,对其后48h内夹闭双侧颈总动脉所致的严重脑缺血具有一定程度的保护作用;大鼠椎动脉对脑干及海马的血液供应均存在明显的同侧优势效应,     

Ischemic Postconditioning Fails to Protect against Neonatal Cerebral Stroke

The lack of efficient neuroprotective strategies for neonatal stroke could be ascribed to pathogenic ischemic processes differentiating adults and neonates. We explored this hypothesis using a rat model of neonatal ischemia induced by permanent occlusion of the left distal middle cerebral artery combined with 50 min of occlusion of both common carotid arteries (CCA). Postconditioning was performed by repetitive brief release and occlusion (30 s, 1 and/or 5 min) of CCA after 50 min of CCA occlusion. Alternative reperfusion was generated by controlled release of the bilateral CCA occlusion. Blood-flow velocities in the left internal carotid artery were measured using color-coded pulsed Doppler ultrasound imaging. Cortical perfusion was measured using laser Doppler. Cerebrovascular vasoreactivity was evaluated after inhalation with the hypercapnic gas or inhaled nitric oxide (NO). Whatever the type of serial mechanical interruptions of blood flow at reperfusion, postconditioning did not reduce infarct volume after 72 hours. A gradual perfusion was found during early re-flow both in the left internal carotid artery and in the cortical penumbra. The absence of acute hyperemia during early CCA re-flow, and the lack of NO-dependent vasoreactivity in P7 rat brain could in part explain the inefficiency of ischemic postconditioning after ischemia-reperfusion.     

Model of occlusion-reperfusion arrhythmias of the transplanted heart in rats

Rats with heterotopically transplanted heart were used for modeling of occlusion-reperfusion arrhythmias. Heart transplantation was carried out by performing the anastomoses between the recipient carotid artery and jugular vein and innominate artery and pulmonary artery of the transplant respectively. The reversible ischemia of myocardium was achieved through temporal occlusion of recipient carotid artery supplying transplanted heart. The model is characterised by total denervation of the heart, the absence of pump function, total nature of myocardial ischemia during occlusion of supplying artery, high reproducibility of arrhythmias and the opportunity of repeated use of the animals.     

Potassium nitrate effect on the development of neurological disorders in experimental brain ischemia

Effect of potassium nitrate (KNO₃) on the dynamics of neurological disorders and lethality in rats as sequelae of brain ischemia induced by a single-step bilateral common carotid artery occlusion were investigated in Wistar rats. KNO₃ at a dose of 5 mg/1000 g administered 60 min prior to the occlusion of the two carotid arteries reliably reduced the severity of neurological disorders and lethality in rats.     

Prevalence and outcome of symptomatic carotid lesions in young adults. National Research Council Study Group.

OBJECTIVE--To estimate the prevalence and outcome of symptomatic internal carotid artery lesions in young adults. DESIGN--Multicentre hospital based observational study with five year follow up. SETTING--Seven neurological departments in northern and central Italy. SUBJECTS--240 patients (115 men) aged 15-44 with a recent transient ischaemic attack or stroke in the carotid territory. MAIN OUTCOME MEASURES--(a) Prevalence of symptomatic internal carotid artery stenosis or occlusion detected by continuous wave Doppler ultrasonography at entry; (b) incidence rates of cerebral, cardiac, and non-vascular death; non-fatal stroke; and non-fatal myocardial infarction. RESULTS--Carotid stenoses of 50-99% and occlusions were found in 38 patients (15.8%). Both conditions were significantly more frequent in patients aged over 35 and in those with hypertension, diabetes mellitus, and stroke at entry. The standardised mortality ratio at five years was 10.5 (95% confidence interval 5.0 to 19.3). Survival of patients with stenoses of 0-49% and occlusions was significantly better than that of patients with stenoses of 50-99%. Carotid stenosis of 50-99% was an independent predictor of death (hazard ratio 7.9; 95% confidence interval 2.2 to 29) and non-fatal stroke (hazard ratio 7.4; 1.5 to 37.4). CONCLUSIONS--The prevalence of carotid stenosis or occlusion in young adults after a cerebrovascular event is low. Though patients with high grade symptomatic carotid stenosis are at risk of non-fetal and fetal events, patients with internal artery occlusion apparently have a benign prognosis.     

The appropriate use of carotid endarterectomy

FOR THE FIRST 30 YEARS AFTER CAROTID ENDARTERECTOMY WAS FIRST DEVELOPED, anecdotal evidence was used to identify patients with internal carotid artery disease for whom this procedure would be appropriate. More recently, the appropriateness of carotid endarterectomy for symptomatic patients and asymptomatic subjects has emerged from 7 randomized trials. Risk of stroke and benefit from the procedure are greatest for symptomatic patients with at least 70% stenosis of the internal carotid artery. Within this group, carotid endarterectomy is most beneficial for the following patients: otherwise healthy elderly patients, those with hemispheric transient ischemic attack, those with tandem extracranial and intracranial lesions and those without evidence of collateral vessels. Risk of perioperative stroke and death is higher in the following groups, although they still benefit: patients with widespread leukoaraiosis, those with occlusion of the contralateral internal carotid artery and those with intraluminal thrombus. Patients with 50% to 69% stenosis experience lesser benefit, and some other groups may even be harmed by carotid endarterectomy, including women and patients with transient monocular blindness only. The procedure is indicated for patients presenting with lacunar stroke and for those with a nearly occluded internal carotid artery, but the benefit is muted. Patients with less than 50% stenosis do not benefit. In the largest randomized trial of asymptomatic subjects, the perioperative risk of stroke and death was very low (1.5%), but the results indicated that a prohibitively high number of subjects (83) must be treated to prevent one stroke in 2 years. The subsequent literature reported higher perioperative risks (2.8% to 5.6%). In asymptomatic individuals nearly half of the strokes that occur may be due to heart and small-vessel disease. These limitations counter any potential benefit. Another trial is in progress and may identify subgroups of asymptomatic subjects who would benefit. Meanwhile, most individuals without symptoms fare better with medical care.The prevention of ischemic stroke by surgical means goes back half a century. After initial endorsement of carotid endarterectomy, confusion arose as to the appropriate selection of patients and the allowable risk from the procedure. In the past 2 decades large randomized trials have been used to evaluate the benefit of the procedure for patients with symptomatic and asymptomatic disease of the internal carotid artery. Sufficient time has now passed since the publication of these trials to analyze their impact on practice and to make recommendations about the application of carotid endarterectomy. There is strong evidence of benefit in some symptomatic patients, whereas other patients will not benefit and may even face harm. There is weak statistical and weaker clinical evidence that asymptomatic subjects will survive longer without experiencing stroke if they undergo endarterectomy than if they do not. The evidence supporting carotid angioplasty and stenting remains anecdotal and conflicting.The purpose of the present report is to provide a clinical roadmap to which symptomatic patients and asymptomatic subjects with carotid stenosis are candidates for endarterectomy. The risks and complications of endarterectomy are also reported. The outlook and benefit for symptomatic patients and asymptomatic subjects are so different that the evidence supporting appropriate use of endarterectomy in these 2 groups will be presented separately.     

Involvement of CCR-2 chemokine receptor activation in ischemic preconditioning and postconditioning of brain in mice

The present study has been designed to investigate the potential role of CCR-2 chemokine receptor in ischemic preconditioning as well as postconditioning induced reversal of ischemia-reperfusion injury in mouse brain. Bilateral carotid artery occlusion of 17min followed by reperfusion for 24h was employed in present study to produce ischemia and reperfusion induced cerebral injury in mice. Cerebral infarct size was measured using triphenyltetrazolium chloride staining. Memory was evaluated using elevated plus-maze test and Morris water maze test. Rota rod test was employed to assess motor incoordination. Bilateral carotid artery occlusion followed by reperfusion produced cerebral infarction and impaired memory and motor co-ordination. Three preceding episodes of bilateral carotid artery occlusion for 1min and reperfusion of 1min were employed to elicit ischemic preconditioning of brain, while three episodes of bilateral carotid artery occlusion for 10s and reperfusion of 10s immediately after the completion of were employed to elicit ischemic postconditioning of brain. Both prior ischemic preconditioning as well as ischemic postconditioning immediately after global cerebral ischemia prevented markedly ischemia-reperfusion-induced cerebral injury as measured in terms of infarct size, loss of memory and motor coordination. RS 102895, a selective CCR-2 chemokine receptor antagonist, attenuated the neuroprotective effect of both the ischemic preconditioning as well as postconditioning. It is concluded that the neuroprotective effect of both ischemic preconditioning as well as ischemic postconditioning may involve the activation of CCR-2 chemokine receptors.     

The neurohypophyseal capillary bed. I. Anatomy and arterial supply.

Vascular casts of the pituitary-median eminence complex of mice,rats, dogs, sheep and monkeys were examined with the scanning electron microscope. Microfil-injected specimens of the rabbit and monkey pituitary-median eminence complex were examined by light microscopy after intracranial internal carotid artery occlusion. In each species a common neuropophyseal capillary network was found uniting infundibulum (median eminence), infundibular stem and infundibular process. This capillary bed is supplied from above by superior hypophyseal arteries and from below by inferior hypophyseal arteries. An artery to the infundibular stem was found in some species. With occlusion of the intracranial internal carotid arteries, flow through superior hypophyseal arteries did not occur. Yet the entire neurohypophyseal capillary bed filled upon injection with Microfil. These observations suggest the concept of a restricted arterial supply to the median eminence with drainage to the underlying adenohypophsis on one hand and to the infundibular process with drainage to the systemic circulation on the other must be modifed and that blood flow within the neurohypophyseal capillary bed (between infundibular process and median eminence) occurs.     

Remote ischaemic preconditioning and prevention of cerebral injury

Bilateral carotid artery occlusion of 10 min followed by reperfusion for 24 hr was employed in present study to produce ischaemia and reperfusion induced cerebral injury in mice. Cerebral infarct size was measured using triphenyltetrazolium chloride staining. Short-term memory was evaluated using elevated plus maze. Inclined beam walking test was employed to assess motor incoordination. Bilateral carotid artery occlusion followed by reperfusion produced cerebral infarction and impaired short-term memory, motor co-ordination and lateral push response. A preceding episode of mesenteric artery occlusion for 15 min and reperfusion of 15 min (remote mesenteric ischaemic preconditioning) prevented markedly ischaemia-reperfusion-induced cerebral injury measured in terms of infarct size, loss of short-term memory, motor coordination and lateral push response. Glibenclamide (5 mg/kg, iv) a KATP channel blocker and caffeine (7 mg/kg, iv) an adenosine receptor blocker attenuated the neuroprotective effect of remote mesenteric ischaemic preconditioning. It may be concluded that neuroprotective effect of remote mesenteric ischaemic preconditioning may be due to activation of adenosine receptors and consequent activation of KATP channels in mice.     

Innervation of the human internal carotid arteries under normal conditions and in stenosis]

The neurohistological investigation of a portion of the internal carotid artery removed in operation on the occasion of occlusion revealed afferent, cholinergic and adrenergic nerve elements randomly located in the examined area. The histochemical and electronmicroscopic investigation of the superior cervical sympathetic ganglion removed from 42 patient operated on the occasion of occlusion of the carotid artery revealed a depletion in the ganglia of synaptic active zones, focal absence of catecholamines and neurohistological materials suggests that a substantial role in the process of stenosing of vascular walls is played by sophisticated effects of innervation connections upon the vessel sheaths.     

THE EXERCISE TEST IN ELECTROCARDIOGRAPHY—Detection of Coronary Artery Disease

Master has proposed a test for detection of latent coronary artery disease by means of electrocardiograms made after standard exercises consisting of walking back and forth over two steps. This test was used in routine examinations of airline employees, with the special purpose of evaluating the test for use on apparently normal persons.Of 526 males tested, 283 were under 40 years of age and 243 were aged 40 years or more. Coronary artery disease was indicated in 16 males in whom there was no other evidence of the disease, five of whom had hypertension. No electrocardiographic evidence of coronary artery disease was obtained for three males in whom the disease was diagnosed or was strongly suspected. The test gave nagative results for 16 males whose electrocardiograms made at rest were compatible with coronary artery disease. The percentage of positive results in men under 40 years of age was 4.3; in men over 40, 0.6.Of a control group of 60 women under the age of 35 years, in none of whom coronary artery disease was detected by other means, six had positive response to the test.It is concluded that Master''s criterion for the most common positive finding, a depression in the ST segment of over 0.5 mm., allows too many false positive findings and that a figure of 1.0 mm. to 1.5. mm. would be a better index. A negative finding apparently does not exclude the possibility of coronary artery disease or of coronary occlusion. The usual 12-lead electrocardiogram made at rest appeared to be of greater value in detection of latent coronary artery disease in apparently normal persons.     

Carnitine requirement of vascular endothelial and smooth muscle cells in imminent ischemia

Rats were subjected to bilateral carotid artery occlusion for 30 min, followed by reperfusion for varying time periods. The concentration of reduced and oxidized glutathione, glutathione peroxidase and glutathione reductase were determined in whole brain after varying periods of reperfusion. Lipid peroxidation was also assessed by determining the levels of malondialdehyde (MDA) in the brain. Reperfusion for 1 hr following bilateral carotid artery occlusion resulted in significant decrease in total glutathione (GSH) concentration along with small but significant increase in oxidized glutathione (GSSG) levels. After 4 hr of reperfusion, GSH levels recovered, although GSSG levels remained elevated up to 12 hr of reperfusion. Increase in malondialdehyde levels was also detected in the brain up to 12 hr of reperfusion. Glutathione reductase activity remained significantly low up to 144 hr of reperfusion, while glutathione peroxidase activity remained unaffected. These results demonstrate that oxidative stress is generated in the brain during reperfusion following partial ischemia due to bilateral carotid artery occlusion.     

Evolving possible link between PI3K and NO pathways in neuroprotective mechanism of ischemic postconditioning in mice

The present study was conducted to pharmacologically investigate the influence of NO signaling pathway in PI3K mediated neuroprotective mechanism of ischemic postconditioning (iPoCo). Bilateral carotid artery occlusion (BCAO) of 12 min followed by reperfusion for 24 h was employed to produce ischemia/reperfusion-induced cerebral injury in male Swiss mice. Memory was assessed using Morris water maze test. Degree of motor incoordination was evaluated using inclined beam walk test, rotarod test, and lateral push test. Cerebral infarct size was measured using triphenyltetrazolium chloride staining. Brain acetylcholinesterase activity, thiobarbituric acid reactive species (TBARS), nitrite/nitrate and reduced glutathione (GSH) levels were also estimated. BCAO followed by reperfusion produced significant rise in cerebral infarct size, acetylcholinesterase activity, and TBARS levels along with fall in nitrite/nitrate and GSH levels. A significant impairment of memory and motor coordination was also noted. iPoCo consisting of three episodes of 10 s carotid artery occlusion and reperfusion significantly attenuated infarct size, memory impairment, motor incoordination, and altered biochemicals. iPoCo-induced neuroprotective effects were significantly abolished by wortmannin (a selective PI3K inhibitor). However, administration of l-Arginine (a NO precursor) in the presence of wortmannin restored the protective effect of ischemic postconditioning. It may be concluded that neuroprotective mechanism of iPoCo involves PI3K-mediated pathway with NO signaling as an important downstream step.     

Some aspects of the physiology and anatomy of the cardiovascular system of the ferret, Mustela putorius furo

The resting heart rate was monitored in 50 urethane-anaesthetized (387 +/- 54 beats/min) and 4 conscious (341 +/- 39 beats/min) ferrets. The arterial blood pressure in the anaesthetized animals was 140/110 +/- 35/31 mmHg. The circulatory responses to vagal stimulation, carotid artery occlusion and a variety of humoral agents were examined. The vagal innervation of the heart and of the distribution of the great vessels are described.     

Clinical and angiographic predictors of stroke and death from carotid endarterectomy: systematic review.

OBJECTIVE: To identify risk factors for operative stroke and death from carotid endarterectomy. DESIGN: Systematic review of all studies published since 1980 which related risk of stroke and death to various preoperative clinical and angiographic characteristics, including unpublished data on 1729 patients from the European carotid surgery trial. MAIN OUTCOME MEASURE: Operative risk of stroke and death. RESULTS: Thirty six published studies fulfilled our criteria. The effect of 14 potential risk factors was examined. The odds of stroke and death were decreased in patients with ocular ischaemia alone (amaurosis fugax or retinal artery occlusion) compared with those with cerebral transient ischaemic attack or stroke (seven studies; odds ratio 0.49; 95% confidence interval 0.37 to 0.66; P < 0.00001). The odds were increased in women (seven studies; 1.44; 1.14 to 1.83; P < 0.005), subjects aged > or = 75 years (10 studies: 1.36; 1.09 to 1.71; P < 0.01), and with systolic blood pressure > 180 mm Hg (four studies; 1.82; 1.37 to 2.41; P < 0.0001), peripheral vascular disease (one study; 2.19; 1.40 to 3.60; P < 0.0005), occlusion of the contralateral internal carotid artery (14 studies; 1.91; 1.35 to 2.69; P < 0.0001), stenosis of the ipsilateral internal carotid siphon (five studies; 1.56; 1.03 to 2.36; P = 0.02), and stenosis of the ipsilateral external carotid artery (one study; 1.61; 1.05 to 2.47; P = 0.03). Operative risk was not significantly related to presentation with cerebral transient ischaemic attack versus stroke, diabetes, angina, recent myocardial infarction, current cigarette smoking, or plaque surface irregularity at angiography. Multiple regression analysis of data from the European carotid surgery trial identified cerebral versus ocular events at presentation, female sex, systolic hypertension, and peripheral vascular disease as independent risk factors. CONCLUSIONS: The risk of stroke and death from carotid endarterectomy is related to several clinical and angiographic characteristics. These observations may help clinicians to estimate operative risks for individual patients and will also facilitate more meaningful comparison of the operative risks of different surgeons or at different institutions by allowing some adjustment for differences in case mix.     

Modelling the circle of Willis to assess the effects of anatomical variations and occlusions on cerebral flows

Blood flow in the circle of Willis (CoW) is modelled using the 1-D equations of pressure and flow wave propagation in compliant vessels. The model starts at the left ventricle and includes the largest arteries that supply the CoW. Based on published physiological data, it is able to capture the main features of pulse wave propagation along the aorta, at the brachiocephalic bifurcation and throughout the cerebral arteries. The collateral ability of the complete CoW and its most frequent anatomical variations is studied in normal conditions and after occlusion of a carotid or vertebral artery (VA). Our results suggest that the system does not require collateral pathways through the communicating arteries to adequately perfuse the brain of normal subjects. The communicating arteries become important in cases of missing or occluded vessels, the anterior communicating artery (ACoA) being a more critical collateral pathway than the posterior communicating arteries (PCoAs) if an internal carotid artery (ICA) is occluded. Occlusions of the VAs proved to be far less critical than occlusions of the ICAs. The worst scenario in terms of reduction in the mean cerebral outflows is a CoW without the first segment of an anterior cerebral artery combined with an occlusion of the contralateral ICA. Furthermore, in patients without any severe occlusion of a carotid or VA, the direction of flow measured at the communicating arteries corresponds to the side of the CoW with an absent or occluded artery. Finally, we study the effect of partial occlusions of the communicating arteries on the cerebral flows, which again confirms that the ACoA is a more important collateral pathway than the PCoAs if an ICA is occluded.     

改良线栓法大鼠大脑中动脉阻塞模型的建立

目的对大鼠大脑中动脉阻塞（MCAO）再灌注模型进行改良,通过比较再灌注24h时大鼠神经功能评分、梗死率、模型制作时间、成功率和死亡率等指标评价改良线栓法大鼠MCAO再灌注模型的有效性。方法12只SD大鼠随机分为对照和模型两组,对照组采用分离结扎翼腭动脉,从颈外动脉插入线栓至大脑中动脉。模型组采用不分离结扎翼腭动脉,从颈总动脉分叉处插入线栓至大脑中动脉。阻断大脑中动脉血供2h后将线栓拔出实现再灌注。于再灌注24h时观察脑组织组织病理学改变,计算比较两组大鼠神经功能评分、模型制作时间、模型成功率和死亡率以及鼠脑切片TTC染色测量脑梗死率。结果两组MCAO模型在再灌注24h后大鼠神经功能评分、梗死率、模型成功率和死亡率等方面没有显著差异;模型组的模型制作时间显著少于对照组（P〈0．05）。结论采用不分离结扎翼腭动脉,由颈总动脉插入线栓的改良线栓法是稳定和可靠的MCAO造模方法。