Related Experiment Video
Updated: Oct 23, 2025
09:42
A Fibrin-Enriched and tPA-Sensitive Photothrombotic Stroke Model
Published on: June 4, 2021
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Distinct intra-arterial clot localization affects tissue-level collaterals and venous outflow profiles
Tobias D Faizy1,2, Reza Kabiri1, Soren Christensen3
1Department of Radiology, Stanford University School of Medicine, Stanford, California, USA.
European Journal of Neurology
|August 23, 2021
Summary
Distal vessel occlusion in acute ischemic stroke due to large vessel occlusion (AIS-LVO) is linked to better tissue-level collaterals (TLC) and venous outflow (VO). These factors predict good functional outcomes after thrombectomy.
Area of Science:
- Neurology
- Radiology
- Stroke Medicine
Background:
- Arterial clot location in acute ischemic stroke due to large vessel occlusion (AIS-LVO) influences collateral blood flow to the brain.
- Understanding the interplay between occlusion site, collateral circulation, and venous drainage is crucial for predicting patient outcomes.
Purpose of the Study:
- To investigate the association between the location of arterial occlusion (proximal vs. distal)
- To assess the relationship between occlusion site, tissue-level collaterals (TLC), and venous outflow (VO) profiles.
- To determine the impact of these factors on functional outcomes in AIS-LVO patients.
Main Methods:
- A multicenter retrospective cohort study included AIS-LVO patients undergoing thrombectomy.
- Vessel occlusion was categorized as proximal (PVO) or distal (DVO) using baseline computed tomographic angiography (CTA).
- Tissue-level collaterals (TLC) were assessed using the hypoperfusion intensity ratio on CT perfusion, and venous outflow (VO) was evaluated using the cortical vein opacification score on CTA.
Main Results:
- Of 649 patients, 58% had PVO and 42% had DVO.
- Distal vessel occlusion (DVO) was a significant predictor of favorable TLC (OR=1.77) and VO (OR=7.2).
- DVO, favorable VO, and favorable TLC independently predicted good functional outcomes (modified Rankin Scale), while CTA collaterals did not.
Conclusions:
- Distal vessel occlusion in AIS-LVO patients is associated with improved tissue-level collateral and venous outflow.
- Favorable TLC and VO profiles, driven by DVO, are key predictors of good functional recovery after thrombectomy.
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