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Collaterals and Elusive Ischemic Penumbra

Smit D Patel1, David Liebeskind2

  • 1Neurology Department, UCLA Health, Los Angeles, CA, USA. drsmitpatel1988@gmail.com.

Translational Stroke Research
|December 29, 2022
PubMed

Insights

Collateral blood vessels are vital for patients with intracranial occlusive diseases. Enhanced collateral circulation improves outcomes and survival, especially when reperfusion therapy isn't an option.

Area of Science:

  • Neurology
  • Vascular Biology
  • Medical Imaging

Background:

  • Collateral blood vessels serve as alternative routes for blood supply in the brain.
  • Their role is critical in determining patient prognosis for acute and chronic intracranial occlusive diseases.
  • Adequate collateral circulation is linked to improved functional outcomes and reduced mortality.

Purpose of the Study:

  • To review the anatomy and physiology of collateral circulation.
  • To describe current imaging modalities for measuring collateral status.
  • To identify factors influencing collateral vessel development and function.

Main Methods:

  • Literature review of anatomical and physiological principles.
  • Survey of existing medical imaging techniques (e.g., CT angiography, MR angiography).
  • Analysis of studies investigating factors affecting collateralization.

Main Results:

  • Collateral circulation significantly impacts outcomes in cerebrovascular diseases.
  • Advanced imaging tools allow for quantitative and qualitative assessment of collaterals.
  • Patient-specific factors and disease characteristics influence collateral status.

Conclusions:

  • Understanding collateral circulation is essential for managing intracranial occlusive diseases.
  • Imaging assessment of collaterals aids in treatment planning and predicting prognosis.
  • Further research into factors influencing collateralization may reveal new therapeutic targets.

Keywords:
Cerebral blood flowCollateral statusDAWNDIFFUSE3Ischemic strokeRevascularizationThrombectomy

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