Patients with a distally located vessel occlusion (DVO) had more favorable tissue-level collateral and venous outflow profiles compared to patients with proximally located occlusions (PVO) in acute ischemic stroke due to large vessel occlusion (AIS-LVO). DVO, favorable tissue-level collaterals, and favorable venous outflow were predictors of good functional outcome.
Why this matters
In patients with AIS-LVO, robust collateral blood flow can help to maintain perfusion and prevent infarction until thrombolytic treatment. Collateral blood flow can be measured using computed tomographic angiography (CTA).
However, CTA collaterals do not fully describe the status of cerebral perfusion. CTA is unable to assess tissue-level collaterals (which instead require computed tomography or magnetic resonance perfusion imaging) and does not account for venous outflow.
Investigating the relationship between AIS-LVO location, tissue-level collaterals and venous outflow, and functional outcomes should help to clarify the importance of cerebral perfusion measures.