Comparison of middle cerebral artery occlusion models conducted by Koizumi and Longa methods: A systematic review and meta-analysis of rodent data

Abstract Ischemic stroke in rodents is usually induced by intraluminal middle cerebral artery occlusion (MCAO) via common carotid artery (CCA) plugging filament invented by Koizumi et al (MCAO-KM), or external carotid artery (CCA) plugging filament created by Longa et al (MCAO-LG). To date, a systematic comparison between the two methods remains missing. Here, we performed a meta-analysis in terms of model establishment, cerebral blood flow (CBF), and cerebral ischemia-reperfusion injury (CIRI) between of them. Literature mining suggests that MCAO-KM brings shorter operation time ( p = 0.007), higher probability of plugging filament ( p < 0.001) and molding establishment ( p = 0.006), lower possibility of subarachnoid hemorrhage (SAH) ( p = 0.02), larger infarct volume ( p = 0.003), and severer brain edema ( p = 0.002) and neurological deficit ( p = 0.03). Nevertheless, MCAO-LG shows more adequate CBF after ischemia-reperfusion ( p < 0.001), higher model survival rate ( p = 0.02), and greater infarct rate ( p = 0.007). In conclusion, the MCAO-KM method is simple to operate with high modeling success rate, and it is suitable for the study of brain edema under long-term hypoperfusion, the MCAO-LG method is highly challenging for novices, and it is suitable for the study of CIRI caused by acute ischemia-reperfusion. These findings are expected to benefit in the selection of intraluminal filament MCAO models prior to undertaking ischemic stroke preclinical effectiveness trials.