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. 2023. "Whole Blood Viscosity and Cerebral Blood Flow in Acute Ischemic Stroke." Seminars in Thrombosis and Hemostasis. https://doi.org/10.1055/s-0043-1775858
Article Title

Whole Blood Viscosity and Cerebral Blood Flow in Acute Ischemic Stroke

ERA Journal ID16856
Article CategoryArticle
AuthorsGyawali, Prajwal, Lillicrap, Thomas P., Garcia-Esperon, Carlos G., Bhattarai, Aseem, Bivard, Andrew and Spratt, Neil
Journal TitleSeminars in Thrombosis and Hemostasis
Year2023
PublisherGeorg Thieme
Place of PublicationUnited States
ISSN0094-6176
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
AbstractExisting 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.
Keywordsacute ischemic stroke; whole blood viscosity; cerebral perfusion; microcirculation
ANZSRC Field of Research 2020320905. Neurology and neuromuscular diseases
320102. Haematology
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Byline AffiliationsSchool 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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