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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

Research output: Contribution to journalReview articlepeer-review

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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

Keywords

  • Brain Ischemia/diagnostic imaging
  • Cerebrovascular Circulation
  • Collateral Circulation
  • Humans
  • Ischemic Stroke
  • Reperfusion
  • Stroke/diagnostic imaging
  • magnetic resonance imaging
  • tomography
  • collateral circulation
  • reperfusion
  • ischemic stroke

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