Cerebral collaterals in acute ischaemia: Implications for acute ischaemic stroke patients receiving reperfusion therapy,European Journal of Neuroscience

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Cerebral collaterals in acute ischaemia: Implications for acute ischaemic stroke patients receiving reperfusion therapy
European Journal of Neuroscience ( IF 2.7 ) Pub Date : 2020-09-01 , DOI: 10.1111/ejn.14955
Abina Vishni Ravindran _{1,

2,

3} , Murray C. Killingsworth _{1,

4,

5} , Sonu Bhaskar _{1,

2,

4,

6,

7}

Affiliation

The cerebral collaterals play an important role in penumbral tissue sustenance after an acute ischaemic stroke. Recent studies have demonstrated the potential role of collaterals in the selection of acute ischaemic stroke patients eligible for reperfusion therapy. However, the understanding of the significance and evidence around the role of collateral status in predicting outcomes in acute ischaemic stroke patients treated with reperfusion therapy is still unclear. Moreover, the use of pre‐treatment collaterals in patient selection and prognosis is relatively underappreciated in clinical settings. A focused review of the literature was performed on the various methods of collateral evaluation and the role of collateral status in acute ischaemic stroke patients receiving reperfusion therapy. We discuss the methods of evaluating pre‐treatment collaterals in clinical settings. The patient selection based on collateral status as well as the prognostic and therapeutic value of collaterals in acute ischaemic stroke, in settings of intravenous thrombolysis or endovascular therapy alone, and bridge therapy, are summarized. Recommendations for future research and possible pharmacological intervention strategies aimed at collateral enhancement are also discussed. Collaterals may play an important role in identifying acute ischaemic stroke patients who are likely to benefit from endovascular treatment in an extended time window. Future neuroscientific efforts to better improve our understanding of the role of collaterals in acute ischaemia as well as clinical studies to delineate its role in patient selection and acute stroke prognosis are warranted.

中文翻译：

急性缺血性脑侧支：对急性缺血性中风患者接受再灌注治疗的意义

脑侧支在急性缺血性中风后在半影组织维持中起重要作用。最近的研究表明，在选择适合再灌注治疗的急性缺血性中风患者中，侧支的潜在作用。但是，对于侧支状态在预测再灌注治疗的急性缺血性中风患者预后中的作用的意义和证据的理解尚不清楚。此外，在临床环境中，对于患者的选择和预后，使用治疗前抵押品相对较少。对侧支评估的各种方法以及侧支状态在接受再灌注治疗的急性缺血性中风患者中的作用进行了文献综述。我们讨论了在临床环境中评估治疗前抵押品的方法。总结了根据侧支状态以及侧支在急性缺血性卒中，单独进行静脉溶栓或血管内治疗以及桥接治疗中的预后和治疗价值的患者选择。还讨论了针对未来研究的建议以及旨在加强侧支的可能的药物干预策略。在确定可能在较长时间窗口内受益于血管内治疗的急性缺血性中风患者中，侧支可能起重要作用。

更新日期：2020-09-01

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