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Journal ArticleDOI

Collateral blood vessels in acute ischaemic stroke: a potential therapeutic target

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TLDR
Imaging of the brain and vessels has shown that collateral flow can sustain brain tissue for hours after the occlusion of major arteries to the brain, and the augmentation or maintenance of collateral flow is therefore a potential therapeutic target.
Abstract
Summary Ischaemic stroke results from acute arterial occlusion leading to focal hypoperfusion. Thrombolysis is the only proven treatment. Advanced neuroimaging techniques allow a detailed assessment of the cerebral circulation in patients with acute stroke, and provide information about the status of collateral vessels and collateral blood flow, which could attenuate the effects of arterial occlusion. Imaging of the brain and vessels has shown that collateral flow can sustain brain tissue for hours after the occlusion of major arteries to the brain, and the augmentation or maintenance of collateral flow is therefore a potential therapeutic target. Several interventions that might augment collateral blood flow are being investigated.

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Journal ArticleDOI

The cerebral collateral circulation: Relevance to pathophysiology and treatment of stroke

TL;DR: The need to develop therapeutic approaches to augment collateral perfusion as an adjunctive strategy to be employed along with, or prior to, thrombolysis and endovascular interventions, is emphasized and the possible potential of inhaled nitric oxide, albumin, and other approaches are highlighted.
Journal ArticleDOI

Neurovascular regulation in the ischemic brain.

TL;DR: Approaches to support collateral flow may ameliorate the outcome of focal cerebral ischemia by rescuing cerebral perfusion in potentially viable regions of the ischemic territory.
Journal ArticleDOI

Clinical Imaging Factors Associated With Infarct Progression in Patients With Ischemic Stroke During Transfer for Mechanical Thrombectomy.

TL;DR: It is suggested that in certain subgroups vascular imaging, including collateral assessment, can play a crucial role in determining the benefits of transfer for thrombectomy, as well as the main determinants of ASPECTS decay.
Journal ArticleDOI

Effect of Collaterals on Clinical Presentation, Baseline Imaging, Complications, and Outcome in Acute Stroke

TL;DR: Collateral circulation is an independent predictor of all outcomes, but the magnitude of significance varies, greater in patients who were recanalization negative versus recAnalization positive.
Journal ArticleDOI

A novel magnetic resonance imaging approach to collateral flow imaging in ischemic stroke.

TL;DR: A novel collateral flow imaging technique is compared with digital subtraction angiography (DSA) for determining collateral circulation in acute stroke and the ability of MR‐based collateral flow maps to predict outcomes after recanalization therapy is evaluated.
References
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Journal ArticleDOI

Classification of subtype of acute ischemic stroke. Definitions for use in a multicenter clinical trial. TOAST. Trial of Org 10172 in Acute Stroke Treatment

TL;DR: The TOAST stroke subtype classification system is easy to use and has good interobserver agreement and should allow investigators to report responses to treatment among important subgroups of patients with ischemic stroke.
Journal ArticleDOI

Thresholds in cerebral ischemia - the ischemic penumbra.

J Astrup, +2 more
- 01 Nov 1981 - 
TL;DR: Recent evidence indicates that immediate failure of basic functions such as synaptic transmission, ion pumping and energy metabolism in the ischemic brain, is critically dependent on residual blood flow, and that these functions fail at certain critical flow thresholds.
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