Inducing Ischemic Stroke via Middle Cerebral Artery Occlusion Using a Thread Bolt

Start with an anesthetized, immobilized rat with the dissected neck area exposing the arteries.

Locate the right common carotid artery or CCA, which bifurcates into the external carotid artery or ECA and the internal carotid artery or ICA, with branches into the middle cerebral artery or MCA.

Ligate the CCA tightly to reduce blood flow.

Next, tie a tight knot on the distal ECA to prevent blood backflow and a loose knot on the ICA.

Place another loose suture around the proximal ECA.

Make a small incision between the ECA knots and insert a thread bolt, a thin filament with a silicone tip.

Then, tighten the loose knot on the ECA to secure the thread bolt and cut the ECA.

Now, loosen the ICA knot and advance the thread bolt until it blocks the MCA.

This blockage restricts blood flow to the brain, inducing neuronal death and resulting in ischemic stroke.

Begin by placing an anesthetized rat on a surgical fixing table. Throughout the surgery, maintain the body temperature of the rats at 37 degrees Celsius in a small animal thermostat. Connect the mouth to the anesthesia machine mask and confirm deep anesthesia by lack of extremity tension, corneal reflexes, and pain.

Fix the rat's limbs to the operating table using paper bandages. With an electric shaver, remove the neck coat and sterilize the neck with 75% alcohol. Use ophthalmic scissors to cut 2 to 3 centimeters along the central longitudinal shape of the neck. And then, with ophthalmic forceps, separate the subcutaneous muscle. Use homemade retractor to fully expose the field of vision.

Care must be taken to present appropriate aseptic technique for all survival surgical procedures. The technique illustrated later in the video should be practiced through the entire procedure. Use the micro-forceps to isolate the common carotid artery, the external carotid artery, and the internal carotid artery.

Working under the microscope, use 8 0 sutures to ligate the common carotid artery with hard knot, external carotid artery far from the heart end with hard knot, internal carotid artery with loose knot, and then to line the external carotid artery near the heart end. Using microscissors, cut a small opening in the external carotid artery and gently insert a thread bolt.

Ligate the suture of the external carotid artery that has been in loose knot and cut off the external carotid artery. Loosen the loose knot of the internal carotid artery, and continue inserting the thread bolt to the beginning of the middle cerebral artery, marked with the suture, and cut off the exposed thread bolt.