Collateral Circulation in Ischemic Stroke: Assessment Tools and Therapeutic Strategies.
Collateral Circulation in Ischemic Stroke: Assessment Tools and Therapeutic Strategies.
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DOI：
10.1161/strokeaha.115.010508
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发表时间：
2015-11
期刊：
影响因子：
8.3
通讯作者：
Liebeskind DS
中科院分区：
文献类型：
--
作者：
Bang OY;Goyal M;Liebeskind DS
传统的血管造影评估具有优势，包括其可靠的闭塞与次全闭塞的显示，标准化的再通分级，以及小脑膜侧支的高分辨率可视化。1,30然而，它有几个限制。首先，由于传统血管造影是侵入性的，它需要更多的专业知识和时间来执行，并且具有较小的血栓事件风险。其次，侧枝血管造影的结果大多是不完整的（例如，不包括静脉期，没有对侧或椎基底动脉视图），特别是在急性情况下。此外，不可能同时检查前支和后支循环衍生的侧支（图1）。最后，在常规血管造影中获得的关于侧支状态对正侧位视图的影响的信息，很难与通常用于描述缺血性损伤的CT或磁共振成像（MRI）的轴向图像相关联。利用CT或MRI（图2）对侧支血流进行了多种可视化研究。
Conventional angiographic evaluation has advantages, including its reliable demonstration of occlusion versus subtotal occlusion, well standardized recanalization grading, and high resolution visualization of leptomeningeal collaterals. 1, 30 However, it has several limitations. First, because conventional angiography is invasive, it requires more expertise and time to perform and carries a small risk of thrombotic events. Second, the results of angiographic collateral studies would mostly be incomplete (eg, not including the venous phase, no contralateral or vertebrobasilar view), especially in acute setting. In addition, it is not possible to simultaneously examine both anterior and poster circulation-derived collaterals (Figure 1). Finally, the information obtained about the effect of collateral status on the anterior and lateral views in conventional angiography cannot easily be correlated with axial images typically used to depict CT or magnetic resonance imaging (MRI) of ischemic injury. Various efforts have been made to visualize collateral flow using CT or MRI (Figure 2).