Cerebral venous collaterals: A new fort for fighting ischemic stroke?
Cerebral venous collaterals: A new fort for fighting ischemic stroke?
复制标题
脑静脉络脉：对抗缺血性中风的新堡垒？
DOI：
10.1016/j.pneurobio.2017.11.001
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发表时间：
2018-04
影响因子：
6.7
通讯作者：
Lou M
中科院分区：
文献类型：
--
作者：
Tong LS;Guo ZN;Ou YB;Yu YN;Zhang XC;Tang J;Zhang JH;Lou M
中风治疗已进入一个新时代，除了静脉溶栓外，还使用血管内治疗。然而，当前治疗方案的功效可能会因其相关的不良事件而降低。例如，过度再灌注和无效的再通可能导致大面积梗塞、脑肿胀、出血并发症和神经功能恶化。对缺血性中风的传统病理生理学理解很难解决这些问题。越来越多的证据表明，功能性脑静脉引流（大脑中的主要血液储存和引流系统）对于中风演变和临床后遗症可能与动脉输注一样重要。进一步探索脑静脉系统的多方面功能可能会对中风结果预测和未来的治疗决策产生新的影响。在这篇综述中，我们强调脑静脉系统的解剖和功能特征，并说明其在病理性卒中内容中促进动脉灌注和维持脑灌注的必要性。然后，我们总结了最近的关键临床研究，这些研究强调了脑静脉侧支循环与先进成像技术的缺血性中风结局之间的关联。提出了一种新颖的三级静脉系统分类，以证明缺血性中风情况下静脉侧支的独特特征。最后，我们讨论了脑静脉侧支评估的当前方向，并根据这些新概念为治疗策略提供了未来的挑战和机遇。
Stroke therapy has entered a new era highlighted by the use of endovascular therapy in addition to intravenous thrombolysis. However, the efficacy of current therapeutic regimens might be reduced by their associated adverse events. For example, over-reperfusion and futile recanalization may lead to large infarct, brain swelling, hemorrhagic complication and neurological deterioration. The traditional pathophysiological understanding on ischemic stroke can hardly address these occurrences. Accumulating evidence suggests that a functional cerebral venous drainage, the major blood reservoir and drainage system in brain, may be as critical as arterial infusion for stroke evolution and clinical sequelae. Further exploration of the multi-faceted function of cerebral venous system may add new implications for stroke outcome prediction and future therapeutic decision-making. In this review, we emphasize the anatomical and functional characteristics of the cerebral venous system and illustrate its necessity in facilitating the arterial infusion and maintaining the cerebral perfusion in the pathological stroke content. We then summarize the recent critical clinical studies that underscore the associations between cerebral venous collateral and outcome of ischemic stroke with advanced imaging techniques. A novel three-level venous system classification is proposed to demonstrate the distinct characteristics of venous collaterals in the setting of ischemic stroke. Finally, we discuss the current directions for assessment of cerebral venous collaterals and provide future challenges and opportunities for therapeutic strategies in the light of these new concepts.
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影响因子：
2.8
作者：
Andeweg, J
通讯作者：
Andeweg, J
Sturge-Weber 综合征的灌注代谢不匹配：多模态成像研究
影响因子：
1.7
作者：
Alkonyi B;Miao Y;Wu J;Cai Z;Hu J;Chugani HT;Juhász C
通讯作者：
Juhász C
影响因子：
11
作者：
Bang, O. Y.;Saver, J. L.;Liebeskind, D. S.
通讯作者：
Liebeskind, D. S.
影响因子：
6.3
作者：
Beard, Daniel J.;McLeod, Damian D.;Spratt, Neil J.
通讯作者：
Spratt, Neil J.
影响因子：
6.3
作者：
Barhoum, Suliman;Langham, Michael C.;Wehrli, Felix W.
通讯作者：
Wehrli, Felix W.