TY - JOUR
T1 - Occult blood flow patterns distal to an occluded artery in acute ischemic stroke
AU - Arrarte Terreros, Nerea
AU - van Willigen, Bettine G.
AU - Niekolaas, Wera S.
AU - Tolhuisen, Manon L.
AU - Brouwer, Josje
AU - Coutinho, Jonathan M.
AU - Beenen, Ludo F.M.
AU - Majoie, Charles B.L.M.
AU - van Bavel, Ed
AU - Marquering, H.A.
PY - 2022/2
Y1 - 2022/2
N2 - Residual blood flow distal to an arterial occlusion in patients with acute ischemic stroke (AIS) is associated with favorable patient outcome. Both collateral flow and thrombus permeability may contribute to such residual flow. We propose a method for discriminating between these two mechanisms, based on determining the direction of flow in multiple branches distal to the occluding thrombus using dynamic Computed Tomography Angiography (dynamic CTA). We analyzed dynamic CTA data of 30 AIS patients and present patient-specific cases that identify typical blood flow patterns and velocities. We distinguished patterns with anterograde (N = 10), retrograde (N = 9), and both flow directions (N = 11), with a large variability in velocities for each flow pattern. The observed flow patterns reflect the interplay between permeability and collaterals. The presented method characterizes distal flow and provides a tool to study patient-specific distal tissue perfusion.
AB - Residual blood flow distal to an arterial occlusion in patients with acute ischemic stroke (AIS) is associated with favorable patient outcome. Both collateral flow and thrombus permeability may contribute to such residual flow. We propose a method for discriminating between these two mechanisms, based on determining the direction of flow in multiple branches distal to the occluding thrombus using dynamic Computed Tomography Angiography (dynamic CTA). We analyzed dynamic CTA data of 30 AIS patients and present patient-specific cases that identify typical blood flow patterns and velocities. We distinguished patterns with anterograde (N = 10), retrograde (N = 9), and both flow directions (N = 11), with a large variability in velocities for each flow pattern. The observed flow patterns reflect the interplay between permeability and collaterals. The presented method characterizes distal flow and provides a tool to study patient-specific distal tissue perfusion.
KW - Acute ischemic stroke
KW - blood flow quantification
KW - collateral circulation
KW - dynamic CTA
KW - thrombus permeability
KW - Humans
KW - Middle Aged
KW - Collateral Circulation
KW - Male
KW - Computed Tomography Angiography
KW - Ischemic Stroke/diagnostic imaging
KW - Cerebral Angiography
KW - Blood Flow Velocity
KW - Aged
KW - Cerebral Arteries/diagnostic imaging
UR - http://www.scopus.com/inward/record.url?scp=85115610603&partnerID=8YFLogxK
U2 - 10.1177/0271678X211044941
DO - 10.1177/0271678X211044941
M3 - Article
C2 - 34550818
SN - 0271-678X
VL - 42
SP - 292
EP - 302
JO - Journal of Cerebral Blood Flow and Metabolism
JF - Journal of Cerebral Blood Flow and Metabolism
IS - 2
ER -