2023
DOI: 10.1007/s00062-023-01296-w
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Distinct Alterations in Oxygenation, Ion Composition and Acid-Base Balance in Cerebral Collaterals During Large-Vessel Occlusion Stroke

Abstract: Purpose Disturbances of blood gas and ion homeostasis including regional hypoxia and massive sodium (Na+)/potassium (K+) shifts are a hallmark of experimental cerebral ischemia but have not been sufficiently investigated for their relevance in stroke patients. Methods We report a prospective observational study on 366 stroke patients who underwent endovascular thrombectomy (EVT) for large-vessel occlusion (LVO) of the anterior circulation (18 December 2018… Show more

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“…First, we utilised a microcatheter-based technique for direct probing from within the centre of an occluded cerebral vascular territory which previously revealed that non-local sample material does not accurately reflect absolute concentrations, cellular composition, or the degree of activation of blood components in the ischaemic brain region. 18 , 19 , 44 , 45 Second, local sample material was obtained within a median time interval of 4 h and 45 min after symptom onset, which is expected to have a beneficial effect on temporal homogeneity in that an early peak of MMP-9 expression may not have been missed. 11 , 15 , 17 Third, a set of strict protocol requirements were in place to avoid observational biases which might result from efforts not requiring, e.g., mandatory vascular imaging or uniform methods to obtain representative sample material of a sufficiently narrow defined target patient population.…”
Section: Discussionmentioning
confidence: 99%
“…First, we utilised a microcatheter-based technique for direct probing from within the centre of an occluded cerebral vascular territory which previously revealed that non-local sample material does not accurately reflect absolute concentrations, cellular composition, or the degree of activation of blood components in the ischaemic brain region. 18 , 19 , 44 , 45 Second, local sample material was obtained within a median time interval of 4 h and 45 min after symptom onset, which is expected to have a beneficial effect on temporal homogeneity in that an early peak of MMP-9 expression may not have been missed. 11 , 15 , 17 Third, a set of strict protocol requirements were in place to avoid observational biases which might result from efforts not requiring, e.g., mandatory vascular imaging or uniform methods to obtain representative sample material of a sufficiently narrow defined target patient population.…”
Section: Discussionmentioning
confidence: 99%