{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T20:09:00Z","timestamp":1791317340255,"version":"4.3.1"},"reference-count":47,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"5","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Stroke"],"published-print":{"date-parts":[[2019,5]]},"abstract":"<jats:sec>\n            <jats:title>Background and Purpose\u2014<\/jats:title>\n            <jats:p>Four-dimensional phase-contrast magnetic resonance imaging enables quantification of blood flow rate (BFR; mL\/min) in multiple cerebral arteries simultaneously, making it a promising technique for hemodynamic investigation in patients with stroke. The aim of this study was to quantify the hemodynamic disturbance and the compensatory pattern of collateral flow in patients with symptomatic carotid stenosis.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods\u2014<\/jats:title>\n            <jats:p>Thirty-eight patients (mean, 72 years; 27 men) with symptomatic carotid stenosis (\u226550%) or occlusion were investigated using 4-dimensional phase-contrast magnetic resonance imaging. For each patient, BFR was measured in 19 arteries\/locations. The ipsilateral side to the symptomatic carotid stenosis was compared with the contralateral side.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results\u2014<\/jats:title>\n            <jats:p>\n              Internal carotid artery BFR was lower on the ipsilateral side (134\u00b187 versus 261\u00b195 mL\/min;\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001). BFR in anterior cerebral artery (A1 segment) was lower on ipsilateral side (35\u00b158 versus 119\u00b172 mL\/min;\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001). Anterior cerebral artery territory bilaterally was primarily supplied by contralateral internal carotid artery. The ipsilateral internal carotid artery mainly supplied the ipsilateral middle cerebral artery (MCA) territory. MCA was also supplied by a reversed BFR found in the ophthalmic and the posterior communicating artery routes on the ipsilateral side (\u22125\u00b128 versus 10\u00b128 mL\/min,\n              <jats:italic>P<\/jats:italic>\n              =0.001, and \u22122\u00b112 versus 6\u00b16 mL\/min,\n              <jats:italic>P<\/jats:italic>\n              =0.03, respectively). Despite these compensations, BFR in MCA was lower on the ipsilateral side, and this laterality was more pronounced in patients with severe carotid stenosis (\u226570%). Although comparing ipsilateral MCA BFR between stenosis groups (&lt;70% and \u226570%), there was no difference (\n              <jats:italic>P<\/jats:italic>\n              =0.95).\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions\u2014<\/jats:title>\n            <jats:p>With a novel approach using 4-dimensional phase-contrast magnetic resonance imaging, we could simultaneously quantify and rank the importance of collateral routes in patients with carotid stenosis. An important observation was that contralateral internal carotid artery mainly secured the bilateral anterior cerebral artery territory. Because of the collateral recruitment, compromised BFR in MCA is not necessarily related to the degree of carotid stenosis. These findings highlight the importance of simultaneous investigation of the hemodynamics of the entire cerebral arterial tree.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/strokeaha.119.024757","type":"journal-article","created":{"date-parts":[[2019,4,4]],"date-time":"2019-04-04T09:01:25Z","timestamp":1554368485000},"page":"1081-1088","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":69,"title":["Blood Flow Lateralization and Collateral Compensatory Mechanisms in Patients With Carotid Artery Stenosis"],"prefix":"10.1161","volume":"50","author":[{"given":"Laleh","family":"Zarrinkoob","sequence":"first","affiliation":[{"name":"From the Department of Pharmacology and Clinical Neuroscience, Ume\u00e5, Sweden (L.Z., J.M.)"},{"name":"Department of Surgical and Perioperative Sciences, Ume\u00e5, Sweden (L.Z.)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anders","family":"W\u00e5hlin","sequence":"additional","affiliation":[{"name":"Department of Radiation Science, Ume\u00e5, Sweden (A.W., K.A., R.B., A.E.)"},{"name":"Centre for Biomedical Engineering and Physics, Ume\u00e5, Sweden (A.W., K.A., A.E.)"},{"name":"Ume\u00e5 Center for Functional Brain Imaging, Sweden (A.W., A.E.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Khalid","family":"Ambarki","sequence":"additional","affiliation":[{"name":"Department of Radiation Science, Ume\u00e5, Sweden (A.W., K.A., R.B., A.E.)"},{"name":"Centre for Biomedical Engineering and Physics, Ume\u00e5, Sweden (A.W., K.A., A.E.)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard","family":"Birgander","sequence":"additional","affiliation":[{"name":"Department of Radiation Science, Ume\u00e5, Sweden (A.W., K.A., R.B., A.E.)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anders","family":"Eklund","sequence":"additional","affiliation":[{"name":"Department of Radiation Science, Ume\u00e5, Sweden (A.W., K.A., R.B., A.E.)"},{"name":"Centre for Biomedical Engineering and Physics, Ume\u00e5, Sweden (A.W., K.A., A.E.)"},{"name":"Ume\u00e5 Center for Functional Brain Imaging, Sweden (A.W., A.E.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan","family":"Malm","sequence":"additional","affiliation":[{"name":"From the Department of Pharmacology and Clinical Neuroscience, Ume\u00e5, Sweden (L.Z., J.M.)"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199108153250701"},{"key":"e_1_3_4_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/0140-6736(91)92916-P"},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.31.6.1346"},{"key":"e_1_3_4_5_2","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-106-1-27"},{"key":"e_1_3_4_6_2","doi-asserted-by":"publisher","DOI":"10.1002\/ana.22354"},{"key":"e_1_3_4_7_2","doi-asserted-by":"crossref","first-page":"1432","DOI":"10.1161\/01.STR.30.7.1432","article-title":"Cerebral hemodynamics in relation to patterns of collateral flow.","volume":"30","author":"Kluytmans M","year":"1999","unstructured":"Kluytmans, M, van der Grond, J, van Everdingen, KJ, Klijn, CJ, Kappelle, LJ, Viergever, MA. Cerebral hemodynamics in relation to patterns of collateral flow. Stroke. 1999;30:1432\u20131439.","journal-title":"Stroke"},{"key":"e_1_3_4_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(10)70185-X"},{"key":"e_1_3_4_9_2","doi-asserted-by":"crossref","first-page":"155","DOI":"10.1161\/01.STR.13.2.155","article-title":"rCBF in patients with carotid occlusion. Resting and hypercapnic flow related to collateral pattern.","volume":"13","author":"Norrving B","year":"1982","unstructured":"Norrving, B, Nilsson, B, Risberg, J. rCBF in patients with carotid occlusion. Resting and hypercapnic flow related to collateral pattern. Stroke. 1982;13:155\u2013162.","journal-title":"Stroke"},{"key":"e_1_3_4_10_2","first-page":"123","article-title":"Blood flow in major cerebral arteries measured by phase-contrast cine MR.","volume":"15","author":"Enzmann DR","year":"1994","unstructured":"Enzmann, DR, Ross, MR, Marks, MP, Pelc, NJ. Blood flow in major cerebral arteries measured by phase-contrast cine MR. AJNR Am J Neuroradiol. 1994;15:123\u2013129.","journal-title":"AJNR Am J Neuroradiol"},{"key":"e_1_3_4_11_2","doi-asserted-by":"publisher","DOI":"10.1038\/jcbfm.2014.241"},{"key":"e_1_3_4_12_2","doi-asserted-by":"publisher","DOI":"10.1002\/jmri.23632"},{"key":"e_1_3_4_13_2","doi-asserted-by":"publisher","DOI":"10.3174\/ajnr.A3664"},{"key":"e_1_3_4_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2006.03.023"},{"key":"e_1_3_4_15_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.114.006622"},{"key":"e_1_3_4_16_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.19.5.604"},{"key":"e_1_3_4_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/0022-3956(75)90026-6"},{"key":"e_1_3_4_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1078-5884(96)80252-8"},{"key":"e_1_3_4_19_2","doi-asserted-by":"publisher","DOI":"10.1161\/str.22.6.2057968"},{"key":"e_1_3_4_20_2","doi-asserted-by":"publisher","DOI":"10.3174\/ajnr.A3442"},{"key":"e_1_3_4_21_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.111.636084"},{"key":"e_1_3_4_22_2","doi-asserted-by":"publisher","DOI":"10.1002\/mrm.21109"},{"key":"e_1_3_4_23_2","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v22.i1.89"},{"key":"e_1_3_4_24_2","doi-asserted-by":"publisher","DOI":"10.1002\/jmri.26641"},{"key":"e_1_3_4_25_2","doi-asserted-by":"publisher","DOI":"10.1167\/iovs.13-11737"},{"key":"e_1_3_4_26_2","doi-asserted-by":"publisher","DOI":"10.1002\/jmri.10133"},{"key":"e_1_3_4_27_2","doi-asserted-by":"publisher","DOI":"10.1002\/jmri.23527"},{"key":"e_1_3_4_28_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.73.6.1223"},{"key":"e_1_3_4_29_2","doi-asserted-by":"publisher","DOI":"10.1161\/hs1201.099892"},{"key":"e_1_3_4_30_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.26.8.1325"},{"key":"e_1_3_4_31_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.10.3.326"},{"key":"e_1_3_4_32_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12883-016-0560-0"},{"key":"e_1_3_4_33_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.111.637314"},{"key":"e_1_3_4_34_2","doi-asserted-by":"publisher","DOI":"10.1159\/000063719"},{"key":"e_1_3_4_35_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.25.9.1784"},{"key":"e_1_3_4_36_2","doi-asserted-by":"publisher","DOI":"10.1002\/ana.410440206"},{"key":"e_1_3_4_37_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.22.1.31"},{"key":"e_1_3_4_38_2","doi-asserted-by":"publisher","DOI":"10.1148\/radiology.207.1.9530305"},{"key":"e_1_3_4_39_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199406023302204"},{"key":"e_1_3_4_40_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1552-6569.2008.00249.x"},{"key":"e_1_3_4_41_2","doi-asserted-by":"publisher","DOI":"10.3171\/jns.1985.63.6.0890"},{"key":"e_1_3_4_42_2","doi-asserted-by":"publisher","DOI":"10.1038\/jcbfm.2014.203"},{"key":"e_1_3_4_43_2","doi-asserted-by":"publisher","DOI":"10.1001\/archneur.55.11.1475"},{"key":"e_1_3_4_44_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0009825"},{"key":"e_1_3_4_45_2","doi-asserted-by":"publisher","DOI":"10.1002\/ana.23554"},{"key":"e_1_3_4_46_2","doi-asserted-by":"publisher","DOI":"10.1038\/nrneurol.2012.147"},{"key":"e_1_3_4_47_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.54.4.878"},{"key":"e_1_3_4_48_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.280.12.1055"}],"container-title":["Stroke"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/STROKEAHA.119.024757","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,13]],"date-time":"2024-05-13T14:50:40Z","timestamp":1715611840000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/STROKEAHA.119.024757"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,5]]},"references-count":47,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2019,5]]}},"alternative-id":["10.1161\/STROKEAHA.119.024757"],"URL":"https:\/\/doi.org\/10.1161\/strokeaha.119.024757","relation":{},"ISSN":["0039-2499","1524-4628"],"issn-type":[{"value":"0039-2499","type":"print"},{"value":"1524-4628","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,5]]},"assertion":[{"value":"2018-11-22","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-03-05","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-04-04","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}