2024
A collateral circulation in ischemic stroke accelerates recanalization due to lower clot compaction
THALEROVÁ, Sandra; Andrea VÍTEČKOVÁ WÜNSCHOVÁ; Patrícia KITTOVÁ; Lucie VAŠÁTKOVÁ; Michaela PEŠKOVÁ et. al.Basic information
Original name
A collateral circulation in ischemic stroke accelerates recanalization due to lower clot compaction
Authors
THALEROVÁ, Sandra (203 Czech Republic, belonging to the institution); Andrea VÍTEČKOVÁ WÜNSCHOVÁ (203 Czech Republic, belonging to the institution); Patrícia KITTOVÁ (703 Slovakia, belonging to the institution); Lucie VAŠÁTKOVÁ (203 Czech Republic); Michaela PEŠKOVÁ (203 Czech Republic, belonging to the institution); Ondřej VOLNÝ (203 Czech Republic); Anna MAC GILLAVRY DANYLEVSKA (804 Ukraine, belonging to the institution); Jan VÍTEČEK (203 Czech Republic); Lukáš KUBALA (203 Czech Republic) and Robert MIKULÍK (203 Czech Republic)
Edition
PLOS ONE, SAN FRANCISCO, PUBLIC LIBRARY SCIENCE, 2024, 1932-6203
Other information
Language
English
Type of outcome
Article in a journal
Field of Study
30210 Clinical neurology
Country of publisher
United States of America
Confidentiality degree
is not subject to a state or trade secret
Impact factor
Impact factor: 2.900 in 2023
RIV identification code
RIV/00216224:14110/24:00137823
Organization unit
Faculty of Medicine
UT WoS
001360846500006
EID Scopus
2-s2.0-85209911131
Keywords in English
clot; collateral; in vitro; Recanalization; Stroke
Tags
International impact, Reviewed
Changed: 23/1/2025 12:18, Mgr. Tereza Miškechová
Abstract
V originále
Collaterals improve recanalization in acute ischemic stroke patients treated with intravenous thrombolysis, but the mechanisms are poorly understood. To investigate it, an in vitro flow model of the middle cerebral artery was developed with or without collaterals. An occlusion was achieved using human blood clots. Recanalization time, thrombolysis (clot length decrease and red blood cell (RBC) release), pressure gradient across the clot and clot compaction were measured. Results showed that with or without collateral alteplase-treated RBC dominant clots showed recanalization time 98±23 min vs 130±35 min (difference 32 min, 95% CI -6-58 min), relative clot reduction 31.8±14.9% vs 30.3±13.2% (difference 1.5%, 95% CI 10.4–13.4%) and RBC release 0.30±0.07 vs 0.27±0.09 (difference 0.03, 95% CI 0.04–0.10). Similar results were observed with fibrin-dominant clots. In RBC dominant clots, the presence vs absence of collateral caused different pressure gradients across the clot 0.41±0.09 vs 0.70±0.09 mmHg (difference 0.29 mmHg, 95% CI -0.17–0.41 mmHg), and caused the reduction of initial clot compaction by 5%. These findings align with observations in patients, where collaterals shortened recanalization time. However, collaterals did not increase thrombolysis. Instead, they decreased the pressure gradient across the clot, resulting in less clot compaction and easier distal displacement of the clot.
Links
| MUNI/A/1564/2023, interní kód MU |
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| NU22-08-00124, research and development project |
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| NU23-08-00499, research and development project |
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| NW24-08-00064, research and development project |
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