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Guidelines
Guidelines for evaluation and management of cerebral collateral circulation in ischaemic stroke 2017
  1. Liping Liu1,
  2. Jing Ding2,
  3. Xinyi Leng3,
  4. Yuehua Pu1,
  5. Li-An Huang4,
  6. Anding Xu4,
  7. Ka Sing Lawrence Wong3,
  8. Xin Wang2,
  9. Yongjun Wang1
  10. on behalf of the Chinese Society of Cerebral Blood Flow and Metabolism, the Chinese Stroke Association
    1. 1 Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
    2. 2 Department of Neurology, Zhongshan Hospital, Fudan University, Shanghai, China
    3. 3 Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong, China
    4. 4 Department of Neurology, The First Affiliated Hospital, Jinan University, Guangzhou, China
    1. Correspondence to Professor Xin Wang; wang.xin{at}zs-hospital.sh.cn and Professor Yongjun Wang; yongjunwang1962{at}gmail.com

    Abstract

    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.

    • collateral circulation
    • ischemic stroke

    This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

    https://doi.org/10.1136/svn-2017-000135

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      Footnotes

      • Contributors LL, JD, XL, YP, L-AH, AX, KSLW: wrote the manuscript. XW, YW: critical revision of the manuscript.

      • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

      • Competing interests None declared.

      • Patient consent Not required.

      • Provenance and peer review Commissioned; externally peer reviewed.

      • Collaborators Jian-Ming Cai (Department of Radiology, The General Hospital of People’s Liberation Army), Tao Chen (Department of Neurology, The First Affiliated Hospital of Kunming Medical University), Xin Chen (Department of Neurology, Huashan Hospital, Fudan University, Shanghai), Jing Ding (Department of Neurology, Zhongshan Hospital, Fudan University, Shanghai), Lian-Bo Gao (Department of Neurology, The Fourth Affiliated Hospital of China Medical University), Yang-Tai Guan (Department of Neurology, Renji Hospital, Shanghai Jiao Tong University School of Medicine), Lawrence KS Wong (Department of Medicine & Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong), Li-An Huang (Department of Neurology, The First Affiliated Hospital, Jinan University), Xin-Yi Leng (Department of Medicine & Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong), Guo-Zhong Li (Department of Neurology, The First Affiliated Hospital of Harbin Medical University), Jing-Wei Li (Department of Neurology, Nanjing Drum Tower Hospital, Nanjing University Medical School), Ye Li (Paul C Lauterbur Research Center for Biomedical Imaging, Shenzhen Institute of Advanced Technology, Chinese Academy of Science), Jia Liu (Shenzhen Institute of Advanced Technology, Chinese Academy of Science), Jun-Yan Liu (Department of Neurology, The Third Affiliated Hospital, Hebei Medical University), Li-Ping Liu (Department of Neurology, Beijing Tiantan Hospital, Capital Medical University), Jie Lu (Department of Radiology, Xuanwu Hospital, Capital Medical University), Qi-Zheng Lu (The Third Affiliated Hospital, Sun Yat-sen University), Yue-Song Pan (Department of Neurology, Beijing Tiantan Hospital, Capital Medical University), Yue-Hua Pu (Department of Neurology, Beijing Tiantan Hospital, Capital Medical University), Xiao-Yi Wang (Shenzhen Delica Medical Equipment), Xin Wang (Department of Neurology, Zhongshan Hospital, Fudan University, Shanghai), Yi-Long Wang (Department of Neurology, Beijing Tiantan Hospital, Capital Medical University), An-Ding Xu (Department of Neurology, The First Affiliated Hospital, Jinan University), Guo-Yuan Yang (Shanghai Med-X Engineering Center for Medical Equipment and Technology), Su-Ming Zhang (Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology) and Xi-Hai Zhao (Center for Biomedical Imaging Research, Tsinghua University).

      • Correction notice This article has been corrected since it published Online First. The author affiliations have been corrected.