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Etiopathogenesis, Diagnosis, Imaging and Treament of Cervicocerebral Artery Dissections: a multifiactorial, multidisciplinary and translational approach (EDIT-CAD-Study)

English title Etiopathogenesis, Diagnosis, Imaging and Treament of Cervicocerebral Artery Dissections: a multifiactorial, multidisciplinary and translational approach (EDIT-CAD-Study)
Applicant Arnold Marcel
Number 124119
Funding scheme SPUM
Research institution Klinik und Poliklinik für Neurologie Inselspital
Institution of higher education University of Berne - BE
Main discipline Clinical Cardiovascular Research
Start/End 01.07.2009 - 30.06.2012
Approved amount 1'591'728.00
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Keywords (6)

Cervicocerebral artery dissection; biomarkers; coagulation markers; MRI; mural hematoma; wall stress

Lay Summary (English)

Lead
Lay summary
Background: Spontaneous cervico-cerebral artery dissection (CAD) is a major cause of stroke in young adults which has a large medical and socioeconomic impact.Aim: To (1) gain new insights into the pathogenic mechanisms and imaging techniques of CAD; and (2) determine new diagnostic biomarkers for the disease using a multifactor, multidiscipline and translational approach.Methods: (1)The subproject "Inflammatory Biochemical and Coagulation Markers in Cervico-cerebral Artery Dissection (BIO-CAD) compares inflammatory biomarkers and coagulation markers in patients with CAD, patients with TIA or stroke of other origin than CAD as one control group, and in healthy individuals as a second control group, by multiplex cytokine array. Furthermore, potential risk factors for CAD, and conventional vascular risk factors will be analysed.2) The subproject "The role of carotid anatomy, distension and displacement in the pathogenesis of carotid artery dissection (CADD-CAD)" will analyse the role of carotid anatomy, distension and displacement in the pathogenesis of CAD using ultrasound, 3 T-MRI, and computational studies. Spontaneous and nitroglycerin-mediated dilatation of the carotid bulb will be measured by carotid ultrasound. High-resolution, diffusion based black-blood 3D imaging will be used to image the carotid bulb in neutral head position and with head rotation and hyperextension. Multi-directional velocity mapping will be performed. For computational studies a finite-element structural model will be used.(3) The subproject "Ex-vivo and in-vivo evaluation of iatrogenic intimal damage and carotid artery dissection during intra-arterial treatment (IAT-CAD)" will use a carotid artery model to investigate the mechanical forces applied on the vessel wall by endovascular procedures and evaluate the risk of intima damage and CAD. Measurements on wall stress will be performed under laboratory conditions ex-vivo (cadaver porcine carotid arteries) and in an animal model (porcine). (4) The subproject "Wall Haematoma in CAD (HAEM-CAD)" will measure location, axial and longitudinal extension and volume of the wall haematoma of the dissected arteries on cervical MRI. It will determine the association between these parameters of the wall haematoma with the degree of carotid obstruction on carotid ultrasound and the presence of local signs on the side of the internal carotid dissection (Horner's syndrome, cranial nerve palsy). Potential Significance: Insights from this multfactorial and translational project will contribute to the understanding of the pathogenesis of CAD and is likely to improve the knowledge on the diagnosis and treatment of this disease.
Direct link to Lay Summary Last update: 21.02.2013

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Associated projects

Number Title Start Funding scheme
140340 Etiopathogenesis, Diagnosis, Imaging and Treatment of Cervicocerebral Artery Dissections: A Multifactorial, Multidisciplinary and Translational Approach 2 (EDIT-CAD-2-Study) 01.07.2012 SPUM

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