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      Guidelines for evaluation and management of cerebral collateral circulation in ischaemic stroke 2017

      research-article
      Author(s): 1 , 2 , 3 , 1 , 4 , 4 , 3 , 2 , 1
      Other contributor(s): (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab)
      Publication date (Electronic):
      Journal: Stroke and Vascular Neurology
      Publisher: BMJ Publishing Group
      Keywords: collateral circulation, ischemic stroke

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          Abstract

          Collateral circulation plays a vital role in sustaining blood flow to the ischaemic areas in acute, subacute or chronic phases after an ischaemic stroke or transient ischaemic attack. Good collateral circulation has shown protective effects towards a favourable functional outcome and a lower risk of recurrence in stroke attributed to different aetiologies or undergoing medical or endovascular treatment. Over the past decade, the importance of collateral circulation has attracted more attention and is becoming a hot spot for research. However, the diversity in imaging methods and criteria to evaluate collateral circulation has hindered comparisons of findings from different cohorts and further studies in exploring the clinical relevance of collateral circulation and possible methods to enhance collateral flow. The statement is aimed to update currently available evidence and provide evidence-based recommendations regarding grading methods for collateral circulation, its significance in patients with stroke and methods under investigation to improve collateral flow.

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          Most cited references105

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          Thrombectomy for Stroke at 6 to 16 Hours with Selection by Perfusion Imaging

          Gregory W Albers, Michael Marks, Stephanie Kemp … (2018)
          New England Journal of Medicine, 378(8), 708-718
          Article 0 comments Cited 1004 times – based on 0 reviews     Review now
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            Randomized Assessment of Rapid Endovascular Treatment of Ischemic Stroke

            Mayank Goyal, Andrew M Demchuk, Bijoy K. Menon … (2015)
            Among patients with a proximal vessel occlusion in the anterior circulation, 60 to 80% of patients die within 90 days after stroke onset or do not regain functional independence despite alteplase treatment. We evaluated rapid endovascular treatment in addition to standard care in patients with acute ischemic stroke with a small infarct core, a proximal intracranial arterial occlusion, and moderate-to-good collateral circulation. We randomly assigned participants to receive standard care (control group) or standard care plus endovascular treatment with the use of available thrombectomy devices (intervention group). Patients with a proximal intracranial occlusion in the anterior circulation were included up to 12 hours after symptom onset. Patients with a large infarct core or poor collateral circulation on computed tomography (CT) and CT angiography were excluded. Workflow times were measured against predetermined targets. The primary outcome was the score on the modified Rankin scale (range, 0 [no symptoms] to 6 [death]) at 90 days. A proportional odds model was used to calculate the common odds ratio as a measure of the likelihood that the intervention would lead to lower scores on the modified Rankin scale than would control care (shift analysis). The trial was stopped early because of efficacy. At 22 centers worldwide, 316 participants were enrolled, of whom 238 received intravenous alteplase (120 in the intervention group and 118 in the control group). In the intervention group, the median time from study CT of the head to first reperfusion was 84 minutes. The rate of functional independence (90-day modified Rankin score of 0 to 2) was increased with the intervention (53.0%, vs. 29.3% in the control group; P<0.001). The primary outcome favored the intervention (common odds ratio, 2.6; 95% confidence interval, 1.7 to 3.8; P<0.001), and the intervention was associated with reduced mortality (10.4%, vs. 19.0% in the control group; P=0.04). Symptomatic intracerebral hemorrhage occurred in 3.6% of participants in intervention group and 2.7% of participants in control group (P=0.75). Among patients with acute ischemic stroke with a proximal vessel occlusion, a small infarct core, and moderate-to-good collateral circulation, rapid endovascular treatment improved functional outcomes and reduced mortality. (Funded by Covidien and others; ESCAPE ClinicalTrials.gov number, NCT01778335.).
            Article 0 comments Cited 887 times – based on 0 reviews     Review now
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              Endovascular Therapy for Ischemic Stroke with Perfusion-Imaging Selection

              Bruce C.V. Campbell, Peter J. Mitchell, Timothy J Kleinig … (2015)
              New England Journal of Medicine, 372(11), 1009-1018
              Article 0 comments Cited 853 times – based on 0 reviews     Review now
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                Author and article information

                Journal
                Journal ID (nlm-ta): Stroke Vasc Neurol
                Journal ID (iso-abbrev): Stroke Vasc Neurol
                Journal ID (hwp): svnbmj
                Journal ID (publisher-id): svn
                Title: Stroke and Vascular Neurology
                Publisher: BMJ Publishing Group (BMA House, Tavistock Square, London, WC1H 9JR )
                ISSN (Electronic): 2059-8696
                Publication date Collection: September 2018
                Publication date (Electronic): 30 May 2018
                Volume: 3
                Issue: 3
                Pages: 117-130
                Affiliations
                [1 ] departmentDepartment of Neurology , Beijing Tiantan Hospital, Capital Medical University , Beijing, China
                [2 ] departmentDepartment of Neurology , Zhongshan Hospital, Fudan University , Shanghai, China
                [3 ] departmentDepartment of Medicine and Therapeutics , The Chinese University of Hong Kong, Prince of Wales Hospital , Hong Kong, China
                [4 ] departmentDepartment of Neurology , The First Affiliated Hospital, Jinan University , Guangzhou, China
                Author notes
                [Correspondence to ] Professor Xin Wang; wang.xin@ 123456zs-hospital.sh.cn and Professor Yongjun Wang; yongjunwang1962@ 123456gmail.com
                Author information
                http://orcid.org/0000-0001-7300-6647
                Article
                Publisher ID: svn-2017-000135
                DOI: 10.1136/svn-2017-000135
                PMC ID: 6169613
                PubMed ID: 30294467
                SO-VID: af9ef7be-3f57-42e8-aecb-d43680be8bdc
                Copyright © © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
                License:

                This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

                History
                Date received : 19 December 2017
                Date revision received : 10 April 2018
                Date accepted : 12 April 2018
                Categories
                Subject: Guidelines
                Subject: 1506
                Custom metadata
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                Keywords: collateral circulation,ischemic stroke
                Data availability:
                Keywords: collateral circulation, ischemic stroke

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