About this Research Topic

Background

The treatment of acute ischemic stroke has changed dramatically in the last decade. The revolution brought by randomized control trials (RCTs) published in 2015 has caused an increasing number of acute endovascular procedures with a great benefit for numerous patients. Furthermore, in the last years, indications for mechanical thrombectomy have progressively extended in general guidelines as even in common clinical practice. In this context precise indications regarding “boundary treatments”, such as late time window, large core infarcts, low National Institutes of Health Stroke Scale (NIHSS), and distal occlusions are still debated. Collateral circulation plays an essential role in predicting the final outcome, both in the acute and chronic situations, and a better understanding could lead to more precise indications, avoiding potentially risky procedures and futile recanalizations, with better clinical outcome for the patients, as well as saving time and costs for the hospitals.

The understanding of cerebral collateral circulation, starting from anatomy, its development, and its role in acute or chronic ischemic stroke is essential when dealing with this pathology. These aspects are useful both in common clinical practice as well as in clinical research to increase the chance of a better outcome after a cerebral ischemic event.

Neuroradiologists, neurologists, neurointerventionalists, neurosurgeons and anesthesiologists are the main figures involved in the treatment of these complex and disabling pathologies. With this work we want to increase the level of knowledge in the field of cerebral collateral circulation, hemodynamics and neurovascular anatomy, aspects that are crucial in the treatment of acute and chronic ischemic stroke.

This Research Topic welcomes manuscripts supported by the Journal – comprised of original research, brief research report, review, and mini-review – pertaining, but not limited to the following themes:
• Cerebral neurovascular anatomy.
• Acute and chronic ischemic cerebrovascular disease.
• Leptomeningeal collateral circulation and their role in the pathophysiology of acute/chronic cerebral ischemic disease.
• Evaluation of leptomeningeal collateral circulation with artificial intelligence software.
• Collateral anatomy/status, collateral recruitment and collateral function.
• Collateral flow measurement.
• Relationship between collateral status and treatment effect (post-thrombolysis recanalization, or EVT).
• The hemodynamic effects of intracranial collateral circulation.
• Induced hypertension, volume expansion and other strategies to support collaterals.
• The physiology of this complex system and pharmacological strategies to modulate it.
• The relationship between the grades of collateral circulation and the predictability of infarct evolution.
• Interaction between collateral circulation and hemorrhagic transformation of an acute ischemic lesion.
• The role of “venous collateral” circulation in acute and chronic ischemic cerebrovascular disease.

Keywords: acute ischemic stroke, stroke, endovascular thrombectomy, leptomeningeal collateral circulation, neurovascular anatomy, leptomeningeal vessels, circle of Willis, cerebral hemodynamic, extra-intracranial anastomosis, chronic ischemic cerebrovascular disease

Important note: All contributions to this Research Topic must be within the scope of the section and journal to which they are submitted, as defined in their mission statements. Frontiers reserves the right to guide an out-of-scope manuscript to a more suitable section or journal at any stage of peer review.

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