In recent years, endovascular treatment, including pharmaceutical drugs and intervention therapy, has become one of the most effective strategies for stroke patients. However, neurobiological and neurovascular functions, before, during and after endovascular therapy, have not been fully addressed and remain to be clarified. It is extremely important for basic neurovascular scientists and clinicians to understand the neurobiological and neurovascular fundamentals of neuroimaging mismatches and the infarct size of stroke patients, hyperperfusion or hypoperfusion after thrombolysis or thrombolectomy, and brain swelling and hemorrhage after successful thrombolectomy. These clinical mismatches and complexities after endovascular therapy are related to active tissue connections in the neurovascular network and the function of neurobiological and neurovascular components after stroke. This comprehensive review summarizes the fundamental neurobiology and neurovascular function in endovascular therapy for stroke patients, using both basic science research and clinical studies, with a focus on cerebral hemodynamics, cell energy metabolism, and neurovascular injuries such as brain swelling, hemorrhage or over-reperfusion. A major emphasis is the potential role of cerebral collateral circulation and venous circulation during and after endovascular therapy. It is clear that the cerebral hemodynamic balance, venous function, and autoregulation are all involved in endovascular therapy.
- Neurovascular network
- Cerebral veins
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Cerebral blood flow
Cerebral blood flow
Collateral flow index
Cerebral perfusion pressure
computed tomography angiography
Computed tomography perfusion
Computed tomography venography
Digital subtraction angiography
Draining vein pressure
Diffusion weighted imaging
Echo color Doppler
Fluid-attenuated inversion recovery
Glasgow outcome scale
Middle cerebral artery occlusion
Magnetic resonance angiography
Magnetic resonance imaging
Magnetic resonance venography
National Institutes of Health Stroke Scale
Orthogonal polarized spectral
Platelet-derived growth factor
Platelet-derived growth factor-BB
Peroxisome proliferator-activated receptor-gamma
Relative cerebral blood flow
Relative cerebral blood volume
Reactive oxygen species
Recombinant tissue plasminogen activator
Single photon emission computed tomography
Superior sagittal sinus
Susceptibility weighted imaging
Vascular endothelial growth factor
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This work was supported by the National Institutes of Health (P01 NS082184, R01 NS081740, and R01 NS091042 to John H. Zhang), the National Basic Research Program of China (973 Program, 2014CB541600 to Hua Feng), the Major Technology Innovation Project of Southwest Hospital (SWH2016ZDCX1011 to Hua Feng) and the National Natural Science Foundation of China (81220108009 to Hua Feng, 81501002 to Yujie Chen).
Conflict of Interest
The authors declare that there are no conflicts of interest.
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Chen, Y. et al. (2019). Neurovascular Network as Future Therapeutic Targets. In: Lou, M., et al. Cerebral Venous System in Acute and Chronic Brain Injuries. Springer Series in Translational Stroke Research. Springer, Cham. https://doi.org/10.1007/978-3-319-96053-1_1
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Online ISBN: 978-3-319-96053-1