Recruitment of pial collaterals and carotid occlusive disease in large-vessel occlusion ischemic stroke DOI Creative Commons
Niklas Helwig, Marlies Wagner, Alexander Seiler

и другие.

Frontiers in Neurology, Год журнала: 2024, Номер 15

Опубликована: Окт. 28, 2024

Background and purpose Despite the fundamental role of pial collateral vessels in limiting progression ischemic tissue injury acute stroke with large vessel occlusion (LVO), addition to fact that abundance varies naturally from person for genetic reasons, there is limited knowledge regarding potential factors contributing inherent interindividual variation supply. As it has been repeatedly hypothesized chronic carotid occlusive disease may favor collateralization, we aimed investigate association between quantitatively assessed leptomeningeal supply pre-existing stenosis patients due LVO. Materials methods Patients proximal middle cerebral artery (MCA) or without additional internal (ICA) were included. The degree was based on signal variance T2*-weighted time series perfusion-weighted magnetic resonance imaging (PWI). stratified into two groups according quantitative status (poor fair good supply). prevalence high-grade ICA (≥70%) evaluated both groups. Results A total 98 (mean age 68.8 ± 16.1 years, n = 52 (53.1%) whom female individuals) MCA and/or included final analysis. Out these patients, 42 had poor supply, while 56 exhibited Additionally, 18 showed ipsilateral stenosis. After classifying entire cohort their vs. supply), no significant difference proportion Specifically, 6 (14.3%) 12 (21.1%) odds ratio (OR) 1.58, a 95% confidence interval (CI) 0.490–5.685 p- value 0.440. In patient cohort, variance-based significantly correlated initial severity ( r −0.360, p < 0.001), baseline core volume −0.362, functional outcomes (score modified Rankin Scale) at discharge −0.367, 0.01). Conclusion this study, performed observer-independent MRI-based assessment We found those influence demographic clinical variables warrants further exploration future studies. related severity, volume, early outcomes.

Язык: Английский

The pathobiology of neurovascular aging DOI
Monica M. Santisteban, Costantino Iadecola

Neuron, Год журнала: 2025, Номер 113(1), С. 49 - 70

Опубликована: Янв. 1, 2025

Язык: Английский

Процитировано

3
Genetic determinants of insufficiency of the collateral circulation DOI Creative Commons
James E. Faber

Journal of Cerebral Blood Flow & Metabolism, Год журнала: 2025, Номер unknown

Опубликована: Фев. 4, 2025

It has been estimated that approximately two million neurons, sixteen billion synapses and twelve kilometers of axons are lost each minute following anterior large-vessel stroke. The level collateral blood flow become recognized as a primary determinant the pace this loss an important factor in clinical decision-making. Many topics review cover recent developments have not reviewed elsewhere. These include that: number diameter collaterals vary greatly brain other tissues healthy individuals; large percentage individuals deficient collaterals; underlying mechanism arises primarily from naturally occurring polymorphisms genes/genetic loci within pathway drives formation during development; evidence indicates abundance does exhibit sexual dimorphism; collaterals—besides their function endogenous bypass vessels—may physiological role optimizing oxygen delivery. Animal human studies tissues, where available, reviewed. Details many provided so strength findings conclusions can be assessed without consulting original literature. Key questions remain unanswered strategies to address them also discussed.

Язык: Английский

Процитировано

1
Introducing the Futile Recanalization Prediction Score (FRPS): A Novel Approach to Predict and Mitigate Ineffective Recanalization after Endovascular Treatment of Acute Ischemic Stroke DOI Creative Commons
Helen Shen, Bella Huasen, Murray C. Killingsworth

и другие.

Neurology International, Год журнала: 2024, Номер 16(3), С. 605 - 619

Опубликована: Май 30, 2024

Objective: This study aims to develop and validate the Futile Recanalization Prediction Score (FRPS), a novel tool designed predict severity risk of FR aid in pre- post-EVT assessments. Methods: The FRPS was developed using rigorous process involving selection predictor variables based on clinical relevance potential impact. Initial equations were derived from previous meta-analyses refined various statistical techniques. We employed machine learning algorithms, specifically random forest regression, capture nonlinear relationships enhance model performance. Cross-validation with five folds used assess generalizability fit. Results: final included such as age, sex, atrial fibrillation (AF), hypertension (HTN), diabetes mellitus (DM), hyperlipidemia, cognitive impairment, pre-stroke modified Rankin Scale (mRS), systolic blood pressure (SBP), onset-to-puncture time, sICH, NIHSS score. achieved mean R-squared value approximately 0.992. Severity ranges for scores defined mild (FRPS < 66), moderate 66–80), severe > 80). Conclusions: provides valuable insights treatment planning patient management by predicting FR. may improve identification candidates most likely benefit EVT prognostic accuracy post-EVT. Further validation diverse settings is warranted its effectiveness reliability.

Язык: Английский

Процитировано

5
Mechanisms of Autophagy in Ineffective Reperfusion After Ischemic Stroke DOI Open Access

Shangying Bai,

Yuchuan Ding,

Leticia Simo

и другие.

Journal of Neuroscience Research, Год журнала: 2025, Номер 103(1)

Опубликована: Янв. 1, 2025

ABSTRACT Despite significant advancements in achieving high recanalization rates (80%–90%) for large vessel occlusions through mechanical thrombectomy, the issue of “futile recanalization” remains a major clinical challenge. Futile occurs when over half patients fail to experience expected symptom improvement after recanalization, often resulting severe functional impairment or death. Traditionally, this phenomenon has been attributed inadequate blood flow and reperfusion injury. More recently, ongoing neuronal death reperfusion, which leads progression ischemic penumbra into core infarct, termed reperfusion.” This review explores complex role autophagy mechanisms futile following stroke, with focus on its relationship survival. We also examine regulation autophagic activity by epigenetic mechanisms. By investigating autophagy's we aim identify novel pathways precision treatment.

Язык: Английский

Процитировано

0
The immunology of stroke and dementia DOI
Costantino Iadecola, Josef Anrather

Immunity, Год журнала: 2025, Номер 58(1), С. 18 - 39

Опубликована: Янв. 1, 2025

Язык: Английский

Процитировано

0
Predictors of futile recanalization after intravenous thrombolysis in stroke patients transferred for endovascular treatment DOI Creative Commons
Lucio D’Anna, Matteo Foschi, Luke Dixon

и другие.

Journal of Thrombosis and Thrombolysis, Год журнала: 2025, Номер unknown

Опубликована: Фев. 15, 2025

Abstract Some patients with large vessel occlusion (LVO) achieve insufficient clinical improvement (futile recanalization, FR) after intravenous thrombolysis (IVT) during inter-hospital transfer for thrombectomy, while others show good outcomes (effective ER). This study assessed FR and ER rates among treated IVT at non-thrombectomy primary stroke centers (PSCs) aimed to identify predictors of FR. We analyzed data from two PSC registries (2016–2022). Inclusion criteria: treatment, anterior circulation LVO, NIHSS ≥ 6, ASPECTS 5, documented recanalization thrombectomy centers. was defined as a 90-day poor outcome (mRS 3–6) despite LVO on initial angiography. Among 190 post-IVT, 113 (59.5%) had Multivariable analysis identified age (OR = 1.03, 95%CI 1.01–1.07, p 0.021), the 1.13, 1.05–1.22, 0.026), collateral status 0.54, 0.39–0.75, 0.001) independent mortality. A model combining age, NIHSS, score provided highest predictive accuracy is common in LVO-related ischemic Identifying can guide clinicians early decision-making, allowing tailored interventions informed discussions about expected outcomes, potentially leading more optimized patient management. The GOTIC-VTE trial Unique identifier, jRCTs031180124; Registration date, April 06, 2017. Graphical

Язык: Английский

Процитировано

0
Role of Peripheral Blood Regulatory T Cells and IL-2 in the Collateral Circulation of Acute Ischemic Stroke DOI Creative Commons
Simin Zhang,

C. Chandrasekhara Rao,

Mao Wen

и другие.

International Journal of General Medicine, Год журнала: 2025, Номер Volume 18, С. 1075 - 1088

Опубликована: Фев. 1, 2025

Inflammation is recognized as a pivotal factor in the pathophysiology of acute ischemic stroke (AIS) and has potential to influence collateral circulation patients. The objective this investigation was explore link between peripheral regulatory T cells (Tregs), interleukin-2 (IL-2), status circulation. Between September 2023 May 2024, study incorporated 117 AIS patients from neurology department, with 60 identified having good (GCS) 57 poor (PCS). Additionally, control group 46 healthy individuals included. Collateral assessed via computed tomography angiography. levels blood Tregs were quantified through flow cytometry, while IL-2 measured by ELISA. In investigation, diagnosed PCS demonstrated reduced (5.77 ± 1.55%) (7.37 2.61 pg/mL) compared GCS (7.09 1.32%, 9.95 3.58 controls (7.17 1.40%,10.33 4.01 pg/mL). Logistic regression analysis significant associations (p<0.05), diminished both being independent predictors when GCS. A nomogram developed forecast risk factors for circulation, further highlighting plasma biomarkers predicting among diagnostic performance utilizing receiver operating characteristic (ROC) analysis. area under ROC curve (AUC) differentiating ascertained be 0.741 (95% confidence interval [CI]: 0.652-0.830), IL-2, it 0.710 CI: 0.618-0.803). Moreover, combined measurement resulted an AUC 0.779 0.695-0.863). Plasma may function promising prediction status, suggesting new therapeutic approaches aimed at enhancing cerebral providing targets stroke.

Язык: Английский

Процитировано

0
Collateral blood vessels in stroke and ischemic disease: Formation, physiology, rarefaction, remodeling DOI Creative Commons
James E. Faber

Journal of Cerebral Blood Flow & Metabolism, Год журнала: 2025, Номер unknown

Опубликована: Март 12, 2025

Collateral blood vessels are unique, naturally occurring endogenous bypass that provide alternative pathways for oxygen delivery in obstructive arterial conditions and diseases. Surprisingly however, the capacity of collateral circulation to protection varies greatly among individuals, resulting a significant fraction having poor their tissues. We recently reviewed evidence presence naturally-occurring polymorphisms genes determine number diameter collaterals form during development (ie, genetic background), is major contributor this variation. The purpose review summarize current understanding other determinants flow, drawing on both animal human studies. These include level smooth muscle tone collaterals, hemodynamic forces, how (collaterogenesis), de novo formation additional new adulthood, loss with aging cardiovascular risk factor (rarefaction), remodeling (structural lumen enlargement). also emerging not only ischemic but may serve physiological function healthy individuals. Primary focus studies conducted brain, however relevant findings tissues reviewed, as questions future investigation.

Язык: Английский

Процитировано

0
Transcranial ultrasound localization microscopy in moyamoya patients using a clinical ultrasound system DOI Creative Commons
Louise Denis, Elena Meseguer, Augustin Gaudemer

и другие.

Theranostics, Год журнала: 2025, Номер 15(9), С. 4074 - 4083

Опубликована: Март 10, 2025

Background: Deep brain structures are supplied by perforating arteries, which too thin to be observed with non-invasive and widely available clinical imaging methods. In moyamoya disease, main arteries in the base of progressively narrow, grow densely tortuously compensate lack blood supply deep structures. Purpose: The aim this study is evaluate efficacy transcranial ultrasound localization microscopy (ULM) visualizing utilizing a standard low-frame-rate scanner contrast sequences commonly employed hospital settings. Methods: This prospective single-center included ischemic stroke patients not related disease patients. Contrast-enhanced (CEUS) were performed an experienced neurologist images acquired used perform post-processing ULM. ULM density maps compared conventional 3T TOF MRI color Doppler both groups. Results: We group 15 control another 9 between March 2023 2024. had average age 45 ± 14 years (65% male). Perforating captured on all subjects, mean diameter 0.8 0.3 mm patients, while it was possible or (P < 0.05). Moreover, enabled highlight differences healthy subjects those through track distance = Conclusions: Using scanner, CEUS accessible tools, we demonstrate that can facilitate visualization characterization even cases where they previously undetectable using techniques. speculate advent high-frame-rate 3D ULM, technique may find widespread utility hospitals.

Язык: Английский

Процитировано

0
Integrated Strategies for Targeting Arteriogenesis and Angiogenesis After Stroke DOI
Jing Wang,

Taoying Xiong,

Qisi Wu

и другие.

Translational Stroke Research, Год журнала: 2024, Номер unknown

Опубликована: Сен. 3, 2024

Язык: Английский

Процитировано

3