@article{0be2d45aef8640f395f4247c43acc2d2,
title = "Occult blood flow patterns distal to an occluded artery in acute ischemic stroke",
abstract = "Residual blood flow distal to an arterial occlusion in patients with acute ischemic stroke (AIS) is associated with favorable patient outcome. Both collateral flow and thrombus permeability may contribute to such residual flow. We propose a method for discriminating between these two mechanisms, based on determining the direction of flow in multiple branches distal to the occluding thrombus using dynamic Computed Tomography Angiography (dynamic CTA). We analyzed dynamic CTA data of 30 AIS patients and present patient-specific cases that identify typical blood flow patterns and velocities. We distinguished patterns with anterograde (N = 10), retrograde (N = 9), and both flow directions (N = 11), with a large variability in velocities for each flow pattern. The observed flow patterns reflect the interplay between permeability and collaterals. The presented method characterizes distal flow and provides a tool to study patient-specific distal tissue perfusion.",
keywords = "Aged, Blood Flow Velocity, Cerebral Angiography, Cerebral Arteries/diagnostic imaging, Collateral Circulation, Computed Tomography Angiography, Humans, Ischemic Stroke/diagnostic imaging, Male, Middle Aged",
author = "{Arrarte Terreros}, Nerea and {van Willigen}, {Bettine G} and Niekolaas, {Wera S} and Tolhuisen, {Manon L} and Josje Brouwer and Coutinho, {Jonathan M} and Beenen, {Ludo Fm} and Majoie, {Charles Blm} and {van Bavel}, Ed and Marquering, {Henk A}",
note = "Funding Information: The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This project has received funding from the European Union{\textquoteright}s Horizon 2020 research and innovation program under grant agreement No 777072 (INSIST project), and the AMC medical Research BV, Amsterdam UMC, location AMC, under project No 21937. The MR CLEAN registry is partially funded by unrestricted grants from the Applied Scientific Institute for Neuromodulation (Toegepast Wetenschappelijk Instituut voor Neuromodulatie), Erasmus Medical Center, Amsterdam Academic Medical Center and Maastricht University Medical Center. Funding Information: The author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: H.A. Marquering reports co-founder and shareholder of Nico.lab, a company that focuses on the use of artificial intelligence for medical image analysis. C.B.L.M. Majoie reports grants from European Commission during the conduct of the study; grants from CVON/Dutch Heart Foundation, TWIN Foundation, and Stryker, outside the submitted work; and shareholder of Nico.lab. Publisher Copyright: {\textcopyright} The Author(s) 2021.",
year = "2022",
month = feb,
doi = "https://doi.org/10.1177/0271678X211044941",
language = "English",
volume = "42",
pages = "292--302",
journal = "Journal of cerebral blood flow and metabolism",
issn = "0271-678X",
publisher = "Nature Publishing Group",
number = "2",
}