Cerebral Collateral Circulation in the Era of Reperfusion Therapies for Acute Ischemic Stroke

Simone M. Uniken Venema*, Jan Willem Dankbaar, Aad van der Lugt, Diederik W.J. Dippel, H. Bart van der Worp

*Corresponding author for this work

Research output: Contribution to journalReview articleAcademicpeer-review

13 Citations (Scopus)

Abstract

Clinical outcomes of patients with acute ischemic stroke depend in part on the extent of their collateral circulation. A good collateral circulation has also been associated with greater benefit of intravenous thrombolysis and endovascular treatment. Treatment decisions for these reperfusion therapies are increasingly guided by a combination of clinical and imaging parameters, particularly in later time windows. Computed tomography and magnetic resonance imaging enable a rapid assessment of both the collateral extent and cerebral perfusion. Yet, the role of the collateral circulation in clinical decision-making is currently limited and may be underappreciated due to the use of rather coarse and rater-dependent grading methods. In this review, we discuss determinants of the collateral circulation in patients with acute ischemic stroke, report on commonly used and emerging neuroimaging techniques for assessing the collateral circulation, and discuss the therapeutic and prognostic implications of the collateral circulation in relation to reperfusion therapies for acute ischemic stroke.

Original languageEnglish
Pages (from-to)3222-3234
Number of pages13
JournalStroke
Volume53
Issue number10
DOIs
Publication statusPublished - Oct 2022

Bibliographical note

Funding Information:
Dr van der Lugt received research grants from the Dutch Heart Foundation, Brain Foundation Netherlands, The Netherlands Organisation for Health Research and Development, Health Holland Top Sector Life Sciences & Health; unrestricted research grants from Penumbra Inc‚ Stryker, Medtronic, Cerenovus, and Thrombolytic Science, LCC. All paid to his institution. Dr Dippel reports research grants received from the Dutch Heart Foundation, Brain Foundation Netherlands, The Netherlands Organisation for Health Research and Development, Health Holland Top Sector Life Sciences & Health; unrestricted research grants from Penumbra, Inc, Stryker, Medtronic, Cerenovus and Thrombolytic Science, LCC. All paid to his institution. Dr van der Worp is past president of the European Stroke Organisation; received research grants from the Dutch Heart Foundation, Stryker, and the European Union; advisory role for Liva Nova and Bayer. All payments were made to his institution. The other authors report no conflicts.

Funding Information:
Dr Uniken Venema performed this work as coordinator of the trial MR ASAP (Multicenter Randomized Trial of Acute Stroke Treatment in the Ambulance With a Nitroglycerin Patch), which is funded by Netherlands Cardiovascular Research Initiative, an initiative from the Dutch Heart Foundation.

Publisher Copyright:
© 2022 Lippincott Williams and Wilkins. All rights reserved.

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