The Pathophysiology of Collateral Circulation in Acute Ischemic Stroke
Cerebral collateral circulation is a network of blood vessels which stabilizes blood flow and maintains cerebral perfusion whenever the main arteries fail to provide an adequate blood supply, as happens in ischemic stroke. These arterial networks are able to divert blood flow to hypoperfused cerebra...
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-07-01
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| Series: | Diagnostics |
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| Online Access: | https://www.mdpi.com/2075-4418/13/14/2425 |
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| author | Marilena Mangiardi Adriano Bonura Gianmarco Iaccarino Michele Alessiani Maria Cristina Bravi Domenica Crupi Francesca Romana Pezzella Sebastiano Fabiano Enrico Pampana Francesco Stilo Guido Alfano Sabrina Anticoli |
| author_facet | Marilena Mangiardi Adriano Bonura Gianmarco Iaccarino Michele Alessiani Maria Cristina Bravi Domenica Crupi Francesca Romana Pezzella Sebastiano Fabiano Enrico Pampana Francesco Stilo Guido Alfano Sabrina Anticoli |
| author_sort | Marilena Mangiardi |
| collection | DOAJ |
| description | Cerebral collateral circulation is a network of blood vessels which stabilizes blood flow and maintains cerebral perfusion whenever the main arteries fail to provide an adequate blood supply, as happens in ischemic stroke. These arterial networks are able to divert blood flow to hypoperfused cerebral areas. The extent of the collateral circulation determines the volume of the salvageable tissue, the so-called “<i>penumbra</i>”. Clinically, this is associated with greater efficacy of reperfusion therapies (thrombolysis and thrombectomy) in terms of better short- and long-term functional outcomes, lower incidence of hemorrhagic transformation and of malignant oedema, and smaller cerebral infarctions. Recent advancements in brain imaging techniques (CT and MRI) allow us to study these anastomotic networks in detail and increase the likelihood of making effective therapeutic choices. In this narrative review we will investigate the pathophysiology, the clinical aspects, and the possible diagnostic and therapeutic role of collateral circulation in acute ischemic stroke. |
| first_indexed | 2024-03-11T01:09:42Z |
| format | Article |
| id | doaj.art-6bb934462f85453b91510f4e57cae69c |
| institution | Directory Open Access Journal |
| issn | 2075-4418 |
| language | English |
| last_indexed | 2024-03-11T01:09:42Z |
| publishDate | 2023-07-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Diagnostics |
| spelling | doaj.art-6bb934462f85453b91510f4e57cae69c2023-11-18T18:58:40ZengMDPI AGDiagnostics2075-44182023-07-011314242510.3390/diagnostics13142425The Pathophysiology of Collateral Circulation in Acute Ischemic StrokeMarilena Mangiardi0Adriano Bonura1Gianmarco Iaccarino2Michele Alessiani3Maria Cristina Bravi4Domenica Crupi5Francesca Romana Pezzella6Sebastiano Fabiano7Enrico Pampana8Francesco Stilo9Guido Alfano10Sabrina Anticoli11Department of Stroke Unit, San Camillo-Forlanini Hospital, 00152 Rome, ItalyUnit of Neurology, Neurophysiology, Neurobiology, Department of Medicine, Campus Bio-Medico University, 00128 Rome, ItalyUnit of Neurology, Neurophysiology, Neurobiology, Department of Medicine, Campus Bio-Medico University, 00128 Rome, ItalyUnit of Neurology, Neurophysiology, Neurobiology, Department of Medicine, Campus Bio-Medico University, 00128 Rome, ItalyUnit of Neurology, Neurophysiology, Neurobiology, Department of Medicine, Campus Bio-Medico University, 00128 Rome, ItalyUnit of Neurology, Neurophysiology, Neurobiology, Department of Medicine, Campus Bio-Medico University, 00128 Rome, ItalyUnit of Neurology, Neurophysiology, Neurobiology, Department of Medicine, Campus Bio-Medico University, 00128 Rome, ItalyDepartment of Neuroradiology and Interventional Neuroradiology, San Camillo-Forlanini Hospital, 00152 Rome, ItalyDepartment of Neuroradiology and Interventional Neuroradiology, San Camillo-Forlanini Hospital, 00152 Rome, ItalyUnit of Vascular Surgery, Campus Bio-Medico University, 00128 Rome, ItalyDepartment of Radiology and Interventional Radiology, M.G. Vannini Hospital, 00177 Rome, ItalyUnit of Neurology, Neurophysiology, Neurobiology, Department of Medicine, Campus Bio-Medico University, 00128 Rome, ItalyCerebral collateral circulation is a network of blood vessels which stabilizes blood flow and maintains cerebral perfusion whenever the main arteries fail to provide an adequate blood supply, as happens in ischemic stroke. These arterial networks are able to divert blood flow to hypoperfused cerebral areas. The extent of the collateral circulation determines the volume of the salvageable tissue, the so-called “<i>penumbra</i>”. Clinically, this is associated with greater efficacy of reperfusion therapies (thrombolysis and thrombectomy) in terms of better short- and long-term functional outcomes, lower incidence of hemorrhagic transformation and of malignant oedema, and smaller cerebral infarctions. Recent advancements in brain imaging techniques (CT and MRI) allow us to study these anastomotic networks in detail and increase the likelihood of making effective therapeutic choices. In this narrative review we will investigate the pathophysiology, the clinical aspects, and the possible diagnostic and therapeutic role of collateral circulation in acute ischemic stroke.https://www.mdpi.com/2075-4418/13/14/2425acute ischemic strokecollateral circulationspenumbrathrombectomyintravenous thrombolysisanterior brain circulation |
| spellingShingle | Marilena Mangiardi Adriano Bonura Gianmarco Iaccarino Michele Alessiani Maria Cristina Bravi Domenica Crupi Francesca Romana Pezzella Sebastiano Fabiano Enrico Pampana Francesco Stilo Guido Alfano Sabrina Anticoli The Pathophysiology of Collateral Circulation in Acute Ischemic Stroke Diagnostics acute ischemic stroke collateral circulations penumbra thrombectomy intravenous thrombolysis anterior brain circulation |
| title | The Pathophysiology of Collateral Circulation in Acute Ischemic Stroke |
| title_full | The Pathophysiology of Collateral Circulation in Acute Ischemic Stroke |
| title_fullStr | The Pathophysiology of Collateral Circulation in Acute Ischemic Stroke |
| title_full_unstemmed | The Pathophysiology of Collateral Circulation in Acute Ischemic Stroke |
| title_short | The Pathophysiology of Collateral Circulation in Acute Ischemic Stroke |
| title_sort | pathophysiology of collateral circulation in acute ischemic stroke |
| topic | acute ischemic stroke collateral circulations penumbra thrombectomy intravenous thrombolysis anterior brain circulation |
| url | https://www.mdpi.com/2075-4418/13/14/2425 |
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