Whole Blood Viscosity and Cerebral Blood Flow in Acute Ischemic Stroke

Article

Gyawali, Prajwal, Lillicrap, Thomas P., Garcia-Esperon, Carlos G., Bhattarai, Aseem, Bivard, Andrew and Spratt, Neil. 2024. "Whole Blood Viscosity and Cerebral Blood Flow in Acute Ischemic Stroke." Seminars in Thrombosis and Hemostasis. 50 (4), pp. 580-591. https://doi.org/10.1055/s-0043-1775858

Article Title	Whole Blood Viscosity and Cerebral Blood Flow in Acute Ischemic Stroke
ERA Journal ID	16856
Article Category	Article
Authors	Gyawali, Prajwal, Lillicrap, Thomas P., Garcia-Esperon, Carlos G., Bhattarai, Aseem, Bivard, Andrew and Spratt, Neil
Journal Title	Seminars in Thrombosis and Hemostasis
Journal Citation	50 (4), pp. 580-591
Number of Pages	12
Year	2024
Publisher	Georg Thieme
Place of Publication	United States
ISSN	0094-6176
	1098-9064
Digital Object Identifier (DOI)	https://doi.org/10.1055/s-0043-1775858
Web Address (URL)	https://www.thieme-connect.com/products/ejournals/abstract/10.1055/s-0043-1775858
Abstract	Existing effective treatments for ischemic stroke restore blood supply to the ischemic region using thrombolysis or mechanical removal of clot. However, it is increasingly recognized that successful removal of occlusive thrombus from the large artery-recanalization, may not always be accompanied by successful restoration of blood flow to the downstream tissues-reperfusion. Ultimately, brain tissue survival depends on cerebral perfusion, and a functioning microcirculation. Because capillary diameter is often equal to or smaller than an erythrocyte, microcirculation is largely dependent on erythrocyte rheological (hemorheological) factors such as whole blood viscosity (WBV). Several studies in the past have demonstrated elevated WBV in stroke compared with healthy controls. Also, elevated WBV has shown to be an independent risk factor for stroke. Elevated WBV leads to endothelial dysfunction, decreases nitric oxide-dependent flow-mediated vasodilation, and promotes hemostatic alterations/thrombosis, all leading to microcirculation sludging. Compromised microcirculation further leads to decreased cerebral perfusion. Hence, modulating WBV through pharmacological agents might be beneficial to improve cerebral perfusion in stroke. This review discusses the effect of elevated WBV on endothelial function, hemostatic alterations, and thrombosis leading to reduced cerebral perfusion in stroke.
Keywords	acute ischemic stroke; whole blood viscosity; cerebral perfusion; microcirculation
Contains Sensitive Content	Does not contain sensitive content
ANZSRC Field of Research 2020	320905. Neurology and neuromuscular diseases
	320102. Haematology
Public Notes	Files associated with this item cannot be displayed due to copyright restrictions.
Byline Affiliations	School of Health and Medical Sciences
	Hunter Medical Research Institute, Australia
	Institute of Medicine, Nepal
	Royal Melbourne Hospital, Australia
	University of Newcastle

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