Collateral blood vessels in acute ischemic stroke: a physiological window to predict future outcomes

• Published in: Arquivos de neuro-psiquiatria Vol. 74; no. 8; pp. 662 - 670
• Main Authors: Alves, Heitor Castelo Branco Rodrigues, Pacheco, Felipe Torres, Rocha, Antonio J.
• Format: Journal Article
• Language: English
• Published: Rua do Matoso 170, Rio de Janeiro, RJ, CEP 20270-135, Brazil Thieme Revinter Publicações Ltda 01-08-2016; Academia Brasileira de Neurologia - ABNEURO; Academia Brasileira de Neurologia (ABNEURO)
• Subjects: acidente vascular cerebral; angiografia; Blood Flow Velocity; Brain Ischemia - diagnostic imaging; Brain Ischemia - physiopathology; Cerebral Angiography; Cerebrovascular Circulation - physiology; circulação colateral; Collateral Circulation - physiology; Humans; isquemia encefálica; NEUROSCIENCES; perfusão; PSYCHIATRY; REVIEW; Stroke - diagnostic imaging; Stroke - physiopathology; tomografia; brain schemia; acidente vascular cerebral; isquemia encefálica; perfusion; circulação colateral; tomography; perfusão; collateral circulation; tomografia; stroke; angiografia; angiography
• ISSN: 0004-282X; 1678-4227; 1678-4227
• DOI: 10.1590/0004-282X20160050

ABSTRACT
Collateral circulation is a physiologic pathway that protects the brain against ischemic injury and can potentially bypass the effect of a blocked artery, thereby influencing ischemic lesion size and growth. Several recent stroke trials have provided information about the role of collaterals in stroke pathophysiology, and collateral perfusion has been recognized to influence arterial recanalization, reperfusion, hemorrhagic transformation, and neurological outcomes after stroke. Our current aim is to summarize the anatomy and physiology of the collateral circulation and to present and discuss a comprehensible review of the related knowledge, particularly the effects of collateral circulation on the time course of ischemic injury and stroke severity, as well as imaging findings and therapeutic implications.