Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Department of Neurology, Zhongshan Hospital, Fudan University, Shanghai, China.
Stroke Vasc Neurol. 2018 May 30;3(3):117-130. doi: 10.1136/svn-2017-000135. eCollection 2018 Sep.
Collateral circulation plays a vital role in sustaining blood flow to the ischaemic areas in acute, subacute or chronic phases after an ischaemic stroke or transient ischaemic attack. Good collateral circulation has shown protective effects towards a favourable functional outcome and a lower risk of recurrence in stroke attributed to different aetiologies or undergoing medical or endovascular treatment. Over the past decade, the importance of collateral circulation has attracted more attention and is becoming a hot spot for research. However, the diversity in imaging methods and criteria to evaluate collateral circulation has hindered comparisons of findings from different cohorts and further studies in exploring the clinical relevance of collateral circulation and possible methods to enhance collateral flow. The statement is aimed to update currently available evidence and provide evidence-based recommendations regarding grading methods for collateral circulation, its significance in patients with stroke and methods under investigation to improve collateral flow.
侧支循环在急性、亚急性或慢性缺血性卒中和短暂性脑缺血发作后对维持缺血区血流起着至关重要的作用。良好的侧支循环对不同病因引起的卒中和接受药物或血管内治疗的卒中有保护作用,可使功能结局更有利,复发风险更低。在过去的十年中,侧支循环的重要性引起了更多的关注,成为研究热点。然而,由于评估侧支循环的成像方法和标准存在多样性,不同队列的研究结果比较和进一步研究探索侧支循环的临床相关性及其可能的增强侧支血流的方法受到了阻碍。本陈述旨在更新目前的证据,并就侧支循环的分级方法、其在卒中患者中的意义以及正在研究的改善侧支血流的方法提供循证建议。