scholarly journals Understanding and Augmenting Collateral Blood Flow During Ischemic Stroke

10.5772/27044 ◽  
2012 ◽  
Author(s):  
Gomathi Ramakrishnan ◽  
Glenn A. ◽  
Ian R.
Keyword(s):  
Blood Flow ◽  
Ischemic Stroke ◽  
Collateral Blood Flow

Abstract 1122‐000181: Collateral Circulation in Ischemic Stroke is Not Determined by Anatomical Variants of the Cerebral Arteries

2021 ◽  
Vol 1 (S1) ◽  
Author(s):  
Karolina Brzegowy ◽  
Bernard Solewski ◽  
Paweł Brzegowy ◽  
Agata Musiał ◽  
Tadeusz Popiela ◽  
...  
Keyword(s):  
Blood Flow ◽  
Ischemic Stroke ◽  
Collateral Circulation ◽  
Cerebral Arteries ◽  
Anatomical Variations ◽  
Detailed Knowledge ◽  
Collateral Blood Flow ◽  
Posterior Portion ◽  
Cortical Vein ◽  
Anatomical Variants

Introduction : In acute ischemic stroke, collateral circulation determines tissue fate and treatment results. The aim of this study was to evaluate the role of anatomical variations of the Circle of Willis (CoW) in formation of cerebral collateral blood flow in patients with acute M1 occlusion. Methods : This study was a retrospective assessment of radiological examinations of patients with stroke due to middle cerebral artery M1 segment occlusion. All patients underwent mechanical thrombectomy from January 2015 until March 2021. The anatomy of the CoW was assessed on initial CT‐angiography and DSA. CTA was utilized to grade cranial collateral vasculature status and cortical vein opacification score (COVES). Non‐contrast CT scans and ASPECTS scores (using RAPID software) were used to determine the ischemic area. Results : A total of 100 patients were included in the analysis (58 females and 42 males, mean age: 71.6 +/‐ 13.9). We classified the anatomy of the CoW according to its continuity as a full circle. Patients with fully continuous CoW (n = 19) had worse COVES scores than those with CoW incomplete at both anterior and posterior portion (n = 9) (89% vs 68% with COVES 0–2, p = 0.179). No statistically significant results were found when comparing the enhancement of collaterals between these two groups (p = 0.390). The COVES scores were similar for patients with complete and incomplete anterior portions of CoW (77% vs 80% with COVES 0–2, p = 0.812). Patients with incomplete posterior portions of CoW had lower COVES scores than those with complete (80% vs 67% with COVES 0–2, p = 0.206). No statistically significant differences were discovered when comparing different types of the posterior communicating artery (adult, transitional and fetal). Analysis of ischemic areas determined as ASPECTS scores pre‐ and post‐thrombectomy yielded no significant differences between any of the groups. Conclusions : Although certain variants of the CoW have been reported to increase the risk of ischemic stroke, our results show that the anatomy of CoW has no large effect on collateral blood flow during acute M1 occlusion. We presume that the greater role is played by pial arterioles than anatomical variants of major cerebral arteries in cerebral collateral circulation formation. Detailed knowledge about the factors that influence collateral blood flow is crucial as it may aid in identification of patients prone to worse outcomes of ischemic stroke. Anatomical variants of CoW do not play a major role in formation of cerebral collaterals.

scholarly journals Effect of Collateral Blood Flow on Patients Undergoing Endovascular Therapy for Acute Ischemic Stroke

Stroke ◽  
2014 ◽  
Vol 45 (4) ◽  
pp. 1035-1039 ◽  
Author(s):  
Michael P. Marks ◽  
Maarten G. Lansberg ◽  
Michael Mlynash ◽  
Jean-Marc Olivot ◽  
Matus Straka ◽  
...  
Keyword(s):  
Blood Flow ◽  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Endovascular Therapy ◽  
Collateral Blood Flow

scholarly journals Strategies of Collateral Blood Flow Assessment in Ischemic Stroke: Prediction of the Follow-Up Infarct Volume in Conventional and Dynamic CTA

2014 ◽  
Vol 36 (3) ◽  
pp. 488-494 ◽  
Author(s):  
S.E. Beyer ◽  
K.M. Thierfelder ◽  
L. von Baumgarten ◽  
M. Rottenkolber ◽  
F.G. Meinel ◽  
...  
Keyword(s):  
Blood Flow ◽  
Ischemic Stroke ◽  
Infarct Volume ◽  
Collateral Blood Flow

scholarly journals Predictive Value of CT Perfusion Imaging on the Basis of Automatic Segmentation Algorithm to Evaluate the Collateral Blood Flow Status on the Outcome of Reperfusion Therapy for Ischemic Stroke

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Qingsong Gong ◽  
Botao Yu ◽  
Mengjie Wang ◽  
Min Chen ◽  
Haowen Xu ◽  
...  
Keyword(s):  
Blood Flow ◽  
Ischemic Stroke ◽  
Perfusion Imaging ◽  
Ct Perfusion ◽  
Automatic Segmentation ◽  
Reperfusion Therapy ◽  
Segmentation Algorithm ◽  
Collateral Flow ◽  
Collateral Blood Flow ◽  
Ct Perfusion Imaging

Our objective was to study the predictive value of CT perfusion imaging based on automatic segmentation algorithm for evaluating collateral blood flow status in the outcome of reperfusion therapy for ischemic stroke. All data of 30 patients with ischemic stroke reperfusion in our hospital were collected and examined by CT perfusion imaging. Convolutional neural network (CNN) algorithm was used to segment perfusion imaging map and evaluate the results. The patients were grouped by regional leptomeningeal collateral score (rLMCs). Binary logistic regression was used to analyze the independent influencing factors of collateral blood flow on brain CT perfusion. The modified Scandinavian Stroke Scale was used to evaluate the prognosis of patients, and the effects of different collateral flow conditions on prognosis were obtained. The accuracy of CNN segmentation image is 62.61%, the sensitivity is 87.42%, the similarity coefficient is 93.76%, and the segmentation result quality is higher. Blood glucose (95% CI = 0.943, P = 0.028 ) and ischemic stroke history (95% CI = 0.855, P = 0.003 ) were independent factors affecting the collateral blood flow status of stroke patients. CBF (95% CI = 0.818, P = 0.008 ) and CBV (95% CI = 0.796, P = 0.016 ) were independent influencing factors of CT perfusion parameters. After 3 weeks of onset, the prognostic function defect score of the good collateral flow group (11.11%) was lower than that of the poor group (41.67%) ( P < 0.05 ). The automatic segmentation algorithm has more accurate segmentation ability for stroke CT perfusion imaging and plays a good auxiliary role in the diagnosis of clinical stroke reperfusion therapy. The collateral blood flow state based on CT perfusion imaging is helpful to predict the treatment outcome of patients with ischemic stroke and further predict the prognosis of patients.

Abstract TP127: Impact of Smoking on Collateral Blood Flow in Patients With Acute Ischemic Stroke With Large Cerebral Artery Embolic Occlusion

Stroke ◽  
2019 ◽  
Vol 50 (Suppl_1) ◽  
Author(s):  
George K Vilanilam ◽  
Mohammed K Badi ◽  
Emily G McCoy ◽  
Caitlin E D'Souza ◽  
Tara L Becker ◽  
...  
Keyword(s):  
Blood Flow ◽  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Cerebral Artery ◽  
Collateral Blood Flow

scholarly journals Augmenting Collateral Blood Flow during Ischemic Stroke via Transient Aortic Occlusion

2013 ◽  
Vol 34 (1) ◽  
pp. 61-71 ◽  
Author(s):  
Ian R Winship ◽  
Glenn A Armitage ◽  
Gomathi Ramakrishnan ◽  
Bin Dong ◽  
Kathryn G Todd ◽  
...  
Keyword(s):  
Blood Flow ◽  
Ischemic Stroke ◽  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Collateral Circulation ◽  
Aortic Occlusion ◽  
Collateral Flow ◽  
Collateral Blood Flow ◽  
Flow Through ◽  
Transient Aortic Occlusion

Collateral circulation provides an alternative route for blood flow to reach ischemic tissue during a stroke. Blood flow through the cerebral collaterals is a critical predictor of clinical prognosis after stroke and response to recanalization, but data on collateral dynamics and collateral therapeutics are lacking. Here, we investigate the efficacy of a novel approach to collateral blood flow augmentation to increase collateral circulation by optically recording blood flow in leptomeningeal collaterals in a clinically relevant model of ischemic stroke. Using high-resolution laser speckle contrast imaging (LSCI) during thromboembolic middle cerebral artery occlusion (MCAo), we demonstrate that transiently diverting blood flow from peripheral circulation towards the brain via intra-aortic catheter and balloon induces persistent increases in blood flow through anastomoses between the anterior and middle cerebral arteries. Increased collateral flow restores blood flow in the distal middle cerebral artery segments to baseline levels during aortic occlusion and persists for over 1 hour after removal of the aortic balloon. Given the importance of collateral circulation in predicting stroke outcome and response to treatment, and the potential of collateral flow augmentation as an adjuvant or stand-alone therapy for acute ischemic stroke, this data provide support for further development and translation of collateral therapeutics including transient aortic occlusion.

scholarly journals Laser Speckle Contrast Imaging of Collateral Blood Flow during Acute Ischemic Stroke

2010 ◽  
Vol 30 (8) ◽  
pp. 1432-1436 ◽  
Author(s):  
Glenn A Armitage ◽  
Kathryn G Todd ◽  
Ashfaq Shuaib ◽  
Ian R Winship
Keyword(s):  
Blood Flow ◽  
Ischemic Stroke ◽  
Cerebral Arteries ◽  
Artery Occlusion ◽  
Laser Speckle ◽  
Collateral Blood Flow ◽  
Contrast Imaging ◽  
Vessel Occlusion ◽  
Laser Speckle Contrast Imaging ◽  
Speckle Contrast

Collateral vasculature may provide an alternative route for blood flow to reach the ischemic tissue and partially maintain oxygen and nutrient support during ischemic stroke. However, much about the dynamics of stroke-induced collateralization remains unknown. In this study, we used laser speckle contrast imaging to map dynamic changes in collateral blood flow after middle cerebral artery occlusion in rats. We identified extensive anastomatic connections between the anterior and middle cerebral arteries that develop after vessel occlusion and persist for 24 hours. Augmenting blood flow through these persistent yet dynamic anastomatic connections may be an important but relatively unexplored avenue in stroke therapy.

scholarly journals Preserved Collateral Blood Flow in the Endovascular M2CAO Model Allows for Clinically Relevant Profiling of Injury Progression in Acute Ischemic Stroke

PLoS ONE ◽  
2017 ◽  
Vol 12 (1) ◽  
pp. e0169541 ◽  
Author(s):  
Philip Little ◽  
Ola Kvist ◽  
Rikard Grankvist ◽  
Stefan Jonsson ◽  
Peter Damberg ◽  
...  
Keyword(s):  
Blood Flow ◽  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Collateral Blood Flow ◽  
Injury Progression

scholarly journals Failure of Collateral Blood Flow is Associated with Infarct Growth in Ischemic Stroke

2013 ◽  
Vol 33 (8) ◽  
pp. 1168-1172 ◽  
Author(s):  
Bruce CV Campbell ◽  
Søren Christensen ◽  
Brian M Tress ◽  
Leonid Churilov ◽  
Patricia M Desmond ◽  
...  
Keyword(s):  
Blood Flow ◽  
Ischemic Stroke ◽  
Arterial Occlusion ◽  
Perfusion Magnetic Resonance Imaging ◽  
Lesion Volume ◽  
Collateral Flow ◽  
Collateral Blood Flow ◽  
Collateral Vessel ◽  
Magnetic Resonance Imaging Mri ◽  
Simultaneous Assessment

Changes in collateral blood flow, which sustains brain viability distal to arterial occlusion, may impact infarct evolution but have not previously been demonstrated in humans. We correlated leptomeningeal collateral flow, assessed using novel perfusion magnetic resonance imaging (MRI) processing at baseline and 3 to 5 days, with simultaneous assessment of perfusion parameters. Perfusion raw data were averaged across three consecutive slices to increase leptomeningeal collateral vessel continuity after subtraction of baseline signal analogous to digital subtraction angiography. Changes in collateral quality, Tmax hypoperfusion severity, and infarct growth were assessed between baseline and days 3 to 5 perfusion-diffusion MRI. Acute MRI was analysed for 88 patients imaged 3 to 6 hours after ischemic stroke onset. Better collateral flow at baseline was associated with larger perfusion-diffusion mismatch (Spearman's Rho 0.51, P < 0.001) and smaller baseline diffusion lesion volume (Rho − 0.70, P < 0.001). In 30 patients without reperfusion at day 3 to 5, deterioration in collateral quality between baseline and subacute imaging was strongly associated with absolute ( P = 0.02) and relative ( P < 0.001) infarct growth. The deterioration in collateral grade correlated with increased mean Tmax hypoperfusion severity (Rho − 0.68, P < 0.001). Deterioration in Tmax hypoperfusion severity was also significantly associated with absolute ( P = 0.003) and relative ( P = 0.002) infarct growth. Collateral flow is dynamic and failure is associated with infarct growth.

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