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.read more
Citations
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Journal ArticleDOI
A Trial of Imaging Selection and Endovascular Treatment for Ischemic Stroke
Chelsea S. Kidwell,Reza Jahan,Jeffrey Gornbein,Jeffry R. Alger,Val Nenov,Zahra Ajani,Lei Feng,Brett C. Meyer,Scott E Olson,Scott E Olson,Lee H. Schwamm,Albert J Yoo,Randolph S. Marshall,Philip M. Meyers,Dileep R. Yavagal,Max Wintermark,Judy Guzy,Sidney Starkman,Jeffrey L. Saver +18 more
TL;DR: A favorable penumbral pattern on neuroimaging did not identify patients who would differentially benefit from endovascular therapy for acute ischemic stroke, nor was embolectomy shown to be superior to standard care.
Journal ArticleDOI
Pathogenic mechanisms following ischemic stroke
TL;DR: The underlying pathophysiology of ischemic stroke is reviewed and the intertwined pathways that are promising therapeutic targets are revealed, leading to the development of numerous agents that target various injury pathways.
Journal ArticleDOI
Hemorrhagic Transformation after Ischemic Stroke in Animals and Humans
Glen C. Jickling,Dazhi Liu,Boryana Stamova,Bradley P. Ander,Xinhua Zhan,Aigang Lu,Frank R. Sharp +6 more
TL;DR: Though remarkable advances in understanding of HT have been made, additional efforts are needed to translate these discoveries to the clinic and reduce the impact of HT on patients with ischemic stroke.
Journal ArticleDOI
Vascular remodeling after ischemic stroke: mechanisms and therapeutic potentials.
Jialing Liu,Yongting Wang,Yosuke Akamatsu,Chih Cheng Lee,R. Anne Stetler,Michael T. Lawton,Guo-Yuan Yang +6 more
TL;DR: In this paper, the early phase of cerebral blood volume (CBV) increase is likely due to the improvement in collateral flow, also known as arteriogenesis, whereas the late phase of CBV increase is attributed to the surge of angiogenesis.
Journal ArticleDOI
Blood Flow Distribution in Cerebral Arteries
TL;DR: A new method is described to outline the flow profile of the cerebral vascular tree, including reference values, and should be used for grading the collateral flow system.
References
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Journal ArticleDOI
Modelling the circle of Willis to assess the effects of anatomical variations and occlusions on cerebral flows
TL;DR: The results suggest that the system does not require collateral pathways through the communicating arteries to adequately perfuse the brain of normal subjects, and confirms that the anterior communicating artery (ACoA) is a more important collateral pathway than the PCoAs if an ICA is occluded.
Journal ArticleDOI
Mechanisms of ischemic brain damage.
TL;DR: This article provides a brief review of recent developments regarding the pathophysiology of ischemic brain damage, and offers hypotheses explaining the pathogenesis of selective neuronal vulnerability and of tissue infarction, respectively.
Journal ArticleDOI
Impact of collateral flow on tissue fate in acute ischaemic stroke
Oh Young Bang,Jeffrey L. Saver,Brian Buck,Jeffry R. Alger,Sidney Starkman,Bruce Ovbiagele,Doojin Kim,Reza Jahan,Gary Duckwiler,Sa Rah Yoon,Fernando Vinuela,David S Liebeskind +11 more
TL;DR: The data suggest that angiographic collateral grade and penumbral volume interactively shape tissue fate in patients undergoing endovascular recanalisation therapy, and provide complementary information about residual blood flow that may help guide treatment decision making in acute cerebral ischaemia.
Journal ArticleDOI
Collateral Vessels on CT Angiography Predict Outcome in Acute Ischemic Stroke
Matthew B. Maas,Michael H. Lev,Hakan Ay,Aneesh B. Singhal,David M. Greer,Wade S. Smith,Gordon J. Harris,Elkan F. Halpern,André Kemmling,Walter J. Koroshetz,Karen L. Furie +10 more
TL;DR: Most patients with proximal middle cerebral artery occlusion rapidly recruit sufficient collaterals and follow a clinical course similar to patients with no occlusions, but a subset with diminished collateral is at high risk for worsening.
Journal ArticleDOI
The Pattern of Leptomeningeal Collaterals on CT Angiography Is a Strong Predictor of Long-Term Functional Outcome in Stroke Patients With Large Vessel Intracranial Occlusion
Fabricio O Lima,Karen L. Furie,Gisele Sampaio Silva,Michael H. Lev,Erica C.S. Camargo,Aneesh B. Singhal,Gordon J. Harris,Elkan F. Halpern,Walter J. Koroshetz,Wade S. Smith,Albert J Yoo,Raul G Nogueira +11 more
TL;DR: Consistent with angiographic studies, leptomeningeal collaterals on CT angiography are also a reliable marker of good outcome in ischemic stroke.
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