DO YOU NOT KNOW ABOUT THIS?
http://stroke.ahajournals.org/content/47/8/1972.extract?etoc
- Bijoy K. Menon, MD, MSc;
- Mayank Goyal, MD
+ Author Affiliations
- Correspondence to Mayank Goyal, MD, Department of Radiology, Seaman Family MR Research Centre, Foothills Medical Centre, 1403 – 29th St NW, Calgary AB T2N 2T9, Canada. E-mail mgoyal@ucalgary.ca
See related article, p 2061.
Acute ischemic stroke is a story of two
parts; a thrombus blocks anterograde blood flow within the intracranial
arterial tree
while tiny vessels called collaterals sustain
the brain until the thrombus is cleared. The location, size, and type of
thrombus
along with the degree and extent of collaterals
likely determine the patient’s clinical symptoms, the likelihood of
treatment
success and the patient’s prognosis. A major
focus of acute stroke research has been to image and measure various
thrombus
and collateral characteristics that help predict
patient outcomes.(Shit, stop predicting and start solving.)
In vitro studies show that larger clots are less likely to lyse with thrombolytic agents, whereas clots with more surface
area exposed to flowing blood are more likely to lyse early.1 This information can be used to create a theoretical framework for thrombus lysis within the intracranial arterial tree.2
Thrombi in proximal arteries such as the internal carotid or the M1
segment of the middle cerebral artery are likely to have
greater volume than thrombi in smaller more
distal arteries. Independent of thrombus volume, longer thrombi within
the cylindrical
framework of the intracranial arterial tree are
likely to have less relative surface area (at the proximal and distal
ends)
exposed to blood flow. Poor collateral status is
likely to result in less blood flow at the distal end of any thrombi
within
the arterial tree.2 Less number of arterial branches at the proximal and distal ends of thrombi are more likely to result in stasis …
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