Prevention of the collapse of pial collaterals by remote ischemic perconditioning during acute ischemic stroke

Ma, Jun; Ma, Yonglie; Dong, Bin; Bandet, Mischa V; Shuaib, Ashfaq; Winship, Ian R.

doi:10.1177/0271678x16680636

Cited by 42 publications

(48 citation statements)

References 57 publications

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“…Collateral status at the time of occlusion (i.e., number and diameter) is the strongest independent predictor of final infarct volume and is considered crucial for clinical decision-making in stroke treatment [8,60,[64][65][66][67]. The hemodynamic evolution of the collateral circulation is also important since collaterals are thought to be time limited and can fail over time [25,26,68]. The dropout of collaterals during stroke is related to the progression of penumbra to irreversible ischemic infarct and impaired response to treatment [25,26,68].…”

Section: Discussionmentioning

confidence: 99%

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Impaired Collateral Flow in Pial Arterioles of Aged Rats During Ischemic Stroke

Shuaib

et al. 2019

Transl. Stroke Res.

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Cerebral collateral circulation and age are critical factors in determining outcome from acute ischemic stroke. Aging may lead to rarefaction of cerebral collaterals, and thereby accelerate ischemic injury by reducing penumbral blood flow. Dynamic changes in pial collaterals after onset of cerebral ischemia may vary with age but have not been extensively studied. Here, laser speckle contrast imaging (LSCI) and two-photon laser scanning microscopy (TPLSM) were combined to monitor cerebral pial collaterals between the anterior cerebral artery (ACA) and the middle cerebral artery (MCA) in young adult and aged male Sprague Dawley rats during distal middle cerebral artery occlusion (dMCAo). Histological analysis showed that aged rats had significantly greater volumes of ischemic damage than young rats. LSCI showed that cerebral collateral perfusion declined over time after stroke in aged and young rats, and that this decline was significantly greater in aged rats. TPLSM demonstrated that pial arterioles narrowed faster after dMCAo in aged rats compared to young adult rats. Notably, while arteriole vessel narrowing was comparable 4.5 h after ischemic onset in aged and young adult rats, red blood cell velocity was stable in young adults but declined over time in aged rats. Overall, red blood cell flux through pial arterioles was significantly reduced at all time-points after 90 min post-dMCAo in aged rats relative to young adult rats. Thus, collateral failure is more severe in aged rats with significantly impaired pial collateral dynamics (reduced diameter, red blood cell velocity, and red blood cell flux) relative to young adult rats.

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Section: Discussionmentioning

confidence: 99%

“…Cerebral ischemia was induced by bilateral common carotid artery (CCA) ligation in addition with distal MCA ligation [26,27]. Distal MCA ligation and imaging protocols were performed by different individuals, and surgeons inducing ischemia were blind to the experimental group for each rat.…”

Section: Dmcaomentioning

confidence: 99%

Impaired Collateral Flow in Pial Arterioles of Aged Rats During Ischemic Stroke

Shuaib

et al. 2019

Transl. Stroke Res.

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“…The association between insufficient hydration and ischemic CI has been rarely studied despite the potential association via the following pathophysiological mechanism; (1) insufficient hydration is one of the most important factors causing dehydration and (2) dehydration is considered to be associated with the development of cerebral ischemic events [1,14,15], probably because of vascular collapse [16], increased blood viscosity [17], and spasm [18]. While the detailed pathophysiology of CI caused by dehydration is yet to be revealed, our study indicates the importance of sufficient water intake to prevent CI.…”

Section: Discussionmentioning

confidence: 99%

Daily Habit of Water Intake in Patients with Cerebral Infarction before its Onset; Comparison with a Healthy Population: A Cross-Sectional Study

et al. 2019

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Background: While water intake is frequently recommended to prevent cerebral infarction (CI), only few studies have been published on this topic. Objectives: This study retrospectively estimated the daily non-alcohol drink (NAD) intake in CI patients before CI onset and compared it with NAD in healthy subjects. Methods: We performed a cross-sectional study on CI patients in 3 hospitals and healthy subjects in the Kobe Orthopedic and Biomedical Epidemiologic (KOBE) study. Data from 1,287 subjects (274 CI patients and 1,013 healthy subjects) were used for the analyses. By dividing the CI patients into “increased”, “unchanged”, and “decreased” groups according to their current NAD intake, we compared the NAD intake between these 3 groups and healthy subjects by analyses of covariance and the post hoc test, adjusting for sex, age, surveyed month, body mass index, alcohol drinking history, and smoking history. Under the assumption that the NAD intake in the “unchanged” group was equal to the NAD intake before CI onset, the OR of less NAD intake for CI adjusting for the relevant variables in the “unchanged” group and the healthy subjects was calculated; the cut-off point was chosen using Youden’s index. Results: The mean age (mean ± SD) of the participants was 62.8 ± 9.3 years. One hundred and fifty-one patients (36 women) were included in the “increased” group; 105 (30 women), in the “unchanged” group; 18 (2 women), in the “decreased” group; and 1,013 (706 women), in the “healthy” group. The mean NAD intake was 1,702.5 ± 670.2 mL in the “increased” group, 1,494.2 ± 611.2 mL in the “unchanged” group, 1,268.0 ± 596.1 mL in the “decreased” group, and 1,720.6 ± 686.0 mL in the “healthy” group. After adjusting for the relevant variables, a significant difference in NAD intake between the groups was observed (F = 6.1, p < 0.001), and a post hoc test demonstrated significant differences (p < 0.05) in NAD intake between the “healthy” and “unchanged” groups, and between the “increased” and “unchanged” groups. The OR of less NAD intake (<1,570 mL/day, chosen using Youden’s index) for CI was 2.48 (95% CI 1.52–4.07). Conclusion: This study showed that daily NAD intake before CI onset in CI patients was less than that in healthy persons, indicating that sufficient intake of NAD may be protective for CI.

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“…distortion of the overall estimates by static artefacts 76 as well as shallow penetration of the laser rays which requires the surgical removal or thinining of the cavaria for rat cerebral studies. 24 Also, LSCI data cannot be used to directly compare between animals or timepoints without data normalisation.…”

Section: Investigation Of the Potential Of Intervention To Enhance Blmentioning

confidence: 99%

Impact of stroke co-morbidities on cortical collateral flow following ischaemic stroke

Biose

Dewar

Macrae

et al. 2019

J Cereb Blood Flow Metab

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Acute hyperglycaemia and chronic hypertension worsen stroke outcome but their impact on collateral perfusion, a determinant of penumbral life span, is poorly understood. Laser-speckle contrast imaging (LSCI) was used to determine the influence of these stroke comorbidities on cortical perfusion after permanent middle cerebral artery occlusion (pMCAO) in spontaneously hypertensive stroke prone rats (SHRSP) and normotensive Wistar rats. Four independent studies were conducted. In animals without pMCAO, cortical perfusion remained stable over 180 min. Following pMCAO, cortical perfusion was markedly reduced at 30 min then gradually increased, via cortical collaterals, over the subsequent 3.5 h. In the contralateral non-ischaemic hemisphere, perfusion did not change over time. Acute hyperglycaemia (in normotensive Wistar) and chronic hypertension (SHRSP) attenuated the restoration of cortical perfusion after pMCAO. Inhaled nitric oxide did not influence cortical perfusion in SHRSP following pMCAO. Thus, hyperglycaemia at the time of arterial occlusion or pre-existing hypertension impaired the dynamic recruitment of cortical collaterals after pMCAO. The impairment of collateral recruitment may contribute to the detrimental effects these comorbidities have on stroke outcome.

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Prevention of the collapse of pial collaterals by remote ischemic perconditioning during acute ischemic stroke

Cited by 42 publications

References 57 publications

Impaired Collateral Flow in Pial Arterioles of Aged Rats During Ischemic Stroke

Impaired Collateral Flow in Pial Arterioles of Aged Rats During Ischemic Stroke

Daily Habit of Water Intake in Patients with Cerebral Infarction before its Onset; Comparison with a Healthy Population: A Cross-Sectional Study

Impact of stroke co-morbidities on cortical collateral flow following ischaemic stroke

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