The Pathophysiology of Collateral Circulation in Acute Ischemic Stroke

Mangiardi, Marilena; Bonura, Adriano; Iaccarino, Gianmarco; Alessiani, Michele; Bravi, M.; Crupi, Domenica; Pezzella, Francesca Romana; Fabiano, Sebastiano; Pampana, Enrico; Stilo, Francesco; Alfano, Guido; Anticoli, Sabrina

doi:10.3390/diagnostics13142425

Cited by 8 publications

(1 citation statement)

References 61 publications

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“…Це зумовлено тим, що значна кількість досліджень, де вивчали ангіогенез, здійснено на експериментальному матеріалі з застосуванням різних моделей ішемічного ураження мозку [23,24] . На терміни васкуляризації перифокальних відділів інфаркту в померлих можуть впливати об'єм інфаркту, вік хворих, стан судинних колатералей і супутня судинна патологія, застосування лікарських засобів [25].…”

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Morphological peculiarities of revascularization of perifocal areas of brain infarction

Tertyshnyi,

Voloshanska,

Serheieva

2023

Pathologia

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Aim. To study pathomorphological signs of revascularization of perifocal areas of brain infarction in the dynamics of the acute period of the disease. Material and methods. Perifocal areas of brain infarction in patients who died at the 1st, 3rd, 7th, and 14th days were studied. General histopathological study was followed by 10 % ammonium silver impregnation and immunohistochemical examination using monoclonal antibodies Mo a-Hu CD34, Clone QBEnd/10 (“Thermo Fisher Scientific Inc.” – USA) and Mo a-Hu CD105 Endoglin were used. clone: SN6h1 (“DAKO”, Denmark). Vascular density and total cross-sectional area of vessels were studied. For the morphometric study, Videotest – Morphology 5.2.0.158 software (VideoTest LLC) was used. Statistical processing of the obtained data was carried out using the Statistica® for Windows 13.0 software. Results. According to the data of CD34 expression, from the 3rd day in the perifocal areas of brain infarction, the angiogenesis processes were increased: the density of blood vessels increased by 18.48 %, and the total cross-sectional area of vessels increased by 1.93 times. On the 7th day, the maximal vessel density and total cross-sectional area of vessels were registered in these areas; there was a vascular budding, formation of endothelial proliferates, and increased expression of CD105 on the vascular endothelium and pericytes, which indicates the active participation of the latter in angiogenesis. On the 14th day, blood vessel density and indicators of the total cross-sectional area of vessels decreased. During this period, the density of the astrocytes increased in the infarct’s perifocal areas with hypertrophy of their bodies and processes. Conclusions. According to CD34 and CD105 expression data, in the perifocal areas of cerebral infarction, the processes of angiogenesis gradually increase from the 3rd day manifesting by increase in the blood vessel density and total vascular cross-sectional area, as well as in the vascular budding and the formation of endothelial proliferates. Vascular remodeling is accompanied by increased density and hypertrophy of astroglia in the perifocal areas of cerebral infarction.

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Section: обговоренняunclassified

Morphological peculiarities of revascularization of perifocal areas of brain infarction

Tertyshnyi,

Voloshanska,

Serheieva

2023

Pathologia

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The impacts of venous outflow profiles on outcomes among large vessel occlusion patients receiving endovascular treatment in the late window

Gong,

Huang,

Huang

et al. 2024

Eur Radiol

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Collaterals influence oxygen metabolism on admission MRI in acute ischemic stroke

Patural,

Bani-Sadr,

Riva

et al. 2024

Preprint

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IntroductionThis study aimed to correlate cerebral collateral status and MRI-derived oxygen metabolism at admission in acute ischemic stroke (AIS) patients treated with mechanical thrombectomy.MethodsThe HIBISCUS-STROKE cohort (CoHort of Patients to Identify Biological an Imaging markerS of CardiovascUlar Outcomes in Stroke; NCT: 03149705), a single-center observational study, enrolled AIS patients for thrombectomy following MRI triage due to anterior circulation large vessel occlusion treated with mechanical thrombectomy. Dynamic-Susceptibility Contrast perfusion (DSC perfusion), Diffusion-Weighted Imaging (DWI) and penumbral volume (Tmax ≥ 6 secs) were post-processed to generate oxygen extraction fraction (OEF) and cerebral metabolic rate of oxygen (CMRO2) maps within DWI and penumbral anomalies, compared to contralateral areas. Collateral status, assessed via pretreatment digital subtraction angiography, was categorized as poor (0–2) or good (3–4) based on ASITN/SIR collateral grading system score from Higashida.ResultsBetween October 2016 and October 2022, 321 participants were enrolled in the cohort. Of these, 184 (57.3%) were excluded due to missing admission DSC perfusion MRI in 61 patients and artifacts precluding collateral status evaluation on DSA. A total of 137 patients were included (mean age 71 years; 56.2% male). The median National Institutes of Health Stroke Scale (NIHSS) score was 15 (interquartile range [IQR]: 8.0–18.0), and the median time from symptom onset to admission was 96.0 minutes ([IQR]: 78.0–137.0). Patients with good collaterals (78) exhibited a smaller baseline infarct core (median 9.83 mL; (P<0.0001) less impairment cerebral blood flow (CBF) within the DWI lesion (median -65.89%; (P<0.0001), and less severe decrease CMRO2 within the ischemic penumbra (median -17.29%; (P=0.03). Good collaterals were independently associated with a smaller baseline infarct core volume and less decrease in CMRO2 within the ischemic penumbra (respectively OR = 0.94; 95% CI: [0.92; 0.96]; (P<0.0001), and (OR = 1.30; 95% CI: [1.06; 1.82]; P=0.001).ConclusionGood collaterals are associated with a smaller infarct core and better CMRO2 within the ischemic penumbra.

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The Pathophysiology of Collateral Circulation in Acute Ischemic Stroke

Cited by 8 publications

References 61 publications

Morphological peculiarities of revascularization of perifocal areas of brain infarction

Morphological peculiarities of revascularization of perifocal areas of brain infarction

The impacts of venous outflow profiles on outcomes among large vessel occlusion patients receiving endovascular treatment in the late window

Collaterals influence oxygen metabolism on admission MRI in acute ischemic stroke

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