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
Early collateral blood supply and late parenchymal brain damage in patients with middle cerebral artery occlusion.
TL;DR: The presence of a collateral circulation during the first few hours after the stroke reduced the size of the final parenchymal brain damage in patients with middle cerebral artery stem-trunk occlusion and the collateral blood supply was more efficient in patients who had no significant stenosing lesions of the extracranial internal carotid artery.
Journal ArticleDOI
The Cerebral Collateral Circulation 2. Production of Cerebral Infarction by Ischemic Anoxia and its Reversibility in Early Stages
D. Denny-Brown,John S. Meyer +1 more
TL;DR: An attempt has been made to produce varying degrees of failure of the collateral circulation and to examine the resulting functional impairment in terms of neuronal injury as indicated by the electrocorticogram and steady potential (S.P.) .
Journal ArticleDOI
Collaterals in acute stroke: beyond the clot.
TL;DR: The role of collateral flow in acute ischemic stroke is explored and the imaging modalities used to investigate phenomena "beyond the clot" are described.
Journal ArticleDOI
Which Time-to-Peak Threshold Best Identifies Penumbral Flow? A Comparison of Perfusion-Weighted Magnetic Resonance Imaging and Positron Emission Tomography in Acute Ischemic Stroke
Jan Sobesky,O. Zaro Weber,Fritz-Georg Lehnhardt,Volker Hesselmann,Alexander Thiel,Christian Dohmen,Alice K. Jacobs,Michael Neveling,W.-D. Heiss +8 more
TL;DR: This first comparison of quantitative PET-CBF with TTP maps in acute ischemic human stroke indicates that the TTP threshold is crucial to reliably identify the tissue at risk; TTP >4 seconds best identifies penumbral flow; and TTPMaps overestimate the extent of true hemodynamic compromise depending on the size of ischemia.
Journal ArticleDOI
Distal hyperintense vessels on FLAIR: An MRI marker for collateral circulation in acute stroke?
TL;DR: The presence of distal hyperintense vessels before thrombolytic treatment is associated with large diffusion–perfusion mismatch and smaller subacute ischemic lesion volumes in patients with proximal middle cerebral artery occlusion.
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