A collateral circulation in ischemic stroke accelerates recanalization due to lower clot compaction.

Autor: Thalerová S; International Clinical Research Center, St. Anne's University Hospital Brno, Brno, Czech Republic.; Department of Biophysics of Immune System, Institute of Biophysics of the Czech Academy of Sciences, Brno, Czech Republic.; Department of Biochemistry, Faculty of Science, Masaryk University Brno, Brno, Czech Republic., Vítečková Wünschová A; International Clinical Research Center, St. Anne's University Hospital Brno, Brno, Czech Republic.; Department of Anatomy, Faculty of Medicine, Masaryk University Brno, Brno, Czech Republic., Kittová P; International Clinical Research Center, St. Anne's University Hospital Brno, Brno, Czech Republic.; Department of Biophysics of Immune System, Institute of Biophysics of the Czech Academy of Sciences, Brno, Czech Republic.; Department of Biochemistry, Faculty of Medicine, Masaryk University Brno, Brno, Czech Republic., Vašátková L; Department of Biophysics of Immune System, Institute of Biophysics of the Czech Academy of Sciences, Brno, Czech Republic., Pešková M; Department of Biophysics of Immune System, Institute of Biophysics of the Czech Academy of Sciences, Brno, Czech Republic.; Department of Biochemistry, Faculty of Science, Masaryk University Brno, Brno, Czech Republic., Volný O; International Clinical Research Center, St. Anne's University Hospital Brno, Brno, Czech Republic., Mac Gillavry Danylevska A; International Clinical Research Center, St. Anne's University Hospital Brno, Brno, Czech Republic.; Department of Histology and Embryology, Faculty of Medicine, Masaryk University Brno, Brno, Czech Republic., Víteček J; International Clinical Research Center, St. Anne's University Hospital Brno, Brno, Czech Republic.; Department of Biophysics of Immune System, Institute of Biophysics of the Czech Academy of Sciences, Brno, Czech Republic., Kubala L; International Clinical Research Center, St. Anne's University Hospital Brno, Brno, Czech Republic.; Department of Biophysics of Immune System, Institute of Biophysics of the Czech Academy of Sciences, Brno, Czech Republic., Mikulík R; International Clinical Research Center, St. Anne's University Hospital Brno, Brno, Czech Republic.
Jazyk: angličtina
Zdroj: PloS one [PLoS One] 2024 Nov 19; Vol. 19 (11), pp. e0314079. Date of Electronic Publication: 2024 Nov 19 (Print Publication: 2024).
DOI: 10.1371/journal.pone.0314079
Abstrakt: 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.
Competing Interests: The authors have declared that no competing interests exist.
(Copyright: © 2024 Thalerová et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)
Databáze: MEDLINE
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