Striate Artery Infarct After Bilateral Carotid Artery Ligation (BCAL) in a Dog: A Multimodal MRI Study

Lukas Komornik; Ines Lautenschläger; Alessio Vigani; Claudia Iannucci; Antonio Pozzi; Adriano Wang-Leandro; Katrin Beckmann

doi:10.3389/fvets.2020.580256

Striate Artery Infarct After Bilateral Carotid Artery Ligation (BCAL) in a Dog: A Multimodal MRI Study

Front Vet Sci. 2020 Sep 18:7:580256. doi: 10.3389/fvets.2020.580256. eCollection 2020.

Authors

Lukas Komornik¹, Ines Lautenschläger², Alessio Vigani³, Claudia Iannucci³, Antonio Pozzi¹, Adriano Wang-Leandro², Katrin Beckmann⁴

Affiliations

¹ Department of Small Animal Surgery, Small Animal Clinic, Vetsuisse Faculty Zurich, University of Zurich, Zurich, Switzerland.
² Department of Diagnostics and Clinical Services, Clinic for Diagnostic Imaging, Vetsuisse Faculty Zurich, University of Zurich, Zurich, Switzerland.
³ Department of Small Animal Emergency and Critical Care, Small Animal Clinic, Vetsuisse Faculty Zurich, University of Zurich, Zurich, Switzerland.
⁴ Department of Neurology, Small Animal Clinic, Vetsuisse Faculty Zurich, University of Zurich, Zurich, Switzerland.

Abstract

Bilateral carotid artery ligation has been reported as a lifesaving procedure to control severe hemorrhage. However, reports are sparse and little information is available regarding the potential risks associated with this procedure. We report an ischemic brain infarct as a complication after vascular surgery. A 3-year old, male intact border collie was presented for acute onset of forebrain signs 5 days after bilateral carotid artery ligation. Multimodal brain MRI including morphologic sequences, MR angiography, diffusion- and perfusion-weighted images were performed. MRI revealed a well-defined intra-axial lesion of the left caudate nucleus, with increased T2 and decreased T1 signal intensity and moderate heterogeneous peripheral contrast enhancement. The cerebral blood flow was reduced relative to the contralateral caudate nucleus. Images were consistent with a subacute lacunar ischemic infarct of the left striate artery. Additionally, multiple arterio-arterial anastomosis arising from the vertebral arteries were visible in the angiography sequences. Ischemic infarct due to thromboembolism should be considered as a possible complication associated with bilateral carotid artery ligation. Collateral blood supply can develop as early as 5 days after surgery.

Keywords: BCAL; angiography; arterial spin labeling; perfusion imaging; stroke.

Publication types

Case Reports