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Translational Stroke Research
Published in: Translational Stroke Research 4/2016

01-08-2016 | SI: Challenges and Controversies in Translational Stroke Research

Improving Reperfusion Therapies in the Era of Mechanical Thrombectomy

Authors: Italo Linfante, Marilyn J. Cipolla

Published in: Translational Stroke Research | Issue 4/2016

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Abstract

Recent positive clinical trials using mechanical thrombectomy proved that endovascular recanalization is an effective treatment for patients with acute stroke secondary to large vessel occlusions. The trials offer definite evidence that in acute ischemia recanalization is a powerful predictor of good outcome. However, even in the era of rapid and effective recanalization using endovascular approaches, the percentage of patients with good outcomes varies between 33 and 71 %. In addition, the number of patients who are eligible for endovascular thrombectomy is small and usually based on having salvageable tissue on imaging. There is therefore room for improvement to both enhance the effectiveness of current practice and expand treatment to a larger subset of stroke patients. In this review, we highlight some of the most promising approaches to improve endovascular therapy by combining with strategies to enhance collateral perfusion and vascular protection.
Literature
1.
Berkhemer OA, Fransen PS, Beumer D, van den Berg LA, Lingsma HF, Yoo AJ, et al. A randomized trial of intraarterial treatment for acute ischemic stroke. N Engl J Med. 2015;372:11–20.CrossRefPubMed
2.
Goyal M, Demchuk AM, Menon BK, Eesa M, Rempel JL, Thornton J, et al. Randomized assessment of rapid endovascular treatment of ischemic stroke. N Engl J Med. 2015;372:1019–30.CrossRefPubMed
3.
Campbell BC, Mitchell PJ, Kleinig TJ, Dewey HM, Churilov L, Yassi N, et al. Endovascular therapy for ischemic stroke with perfusion-imaging selection. N Engl J Med. 2015;372:1009–18.CrossRefPubMed
4.
Saver JL, Goyal M, Bonafe A, Diener HC, Levy EI, Pereira VM, et al. Stent-retriever thrombectomy after intravenous t-PA vs. t-PA alone in stroke. N Engl J Med. 2015;372:2285–95.CrossRefPubMed
5.
Jovin TG, Chamorro A, Cobo E, de Miquel MA, Molina CA, Rovira A, et al. Thrombectomy within 8 hours after symptom onset in ischemic stroke. N Engl J Med. 2015;372:2296–306.CrossRefPubMed
6.
Dirnagl U, Endres M. Found in translation: preclinical stroke research predicts human pathophysiology, clinical phenotypes, and therapeutic outcomes. Stroke. 2014;45:1510–8.CrossRefPubMed
7.
Cumberland Consensus Working Group 1, Cheeran B, Cohen L, Dobkin B, Ford G, Greenwood R, et al. The future of restorative neurosciences in stroke: driving the translational research pipeline from basic science to rehabilitation of people after stroke. Neurorehabil Neural Repair. 2009;23:97–107.CrossRef
8.
9.
Paciaroni M, Caso V, Agnelli G. The concept of ischemic penumbra in acute stroke and therapeutic opportunities. Eur Neurol. 2009;61:321–30.CrossRefPubMed
10.
The National Institute of Neurological Disorders and Stroke rt-PA Stroke Study Group. Tissue plasminogen activator for acute ischemic stroke. N Engl J Med. 1995;333:1581–7.CrossRef
11.
Ciccone A, Valvassori L, Nichelatti M, Sgoifo A, Ponzio M, Sterzi R, et al. Endovascular treatment for acute ischemic stroke. N Engl J Med. 2013;368:2433–4.CrossRefPubMed
12.
Broderick JP, Palesch YY, Demchuk AM, Yeatts SD, Khatri P, Hill MD, et al. Interventional Management of Stroke (IMS) III Investigators Endovascular therapy after intravenous t-PA versus t-PA alone for stroke. N Engl J Med. 2013;368:893–903.CrossRefPubMedPubMedCentral
13.
Kidwell CS, Jahan R, Gornbein J, Alger JR, Nenov V, Ajani Z, et al. A trial of imaging selection and endovascular treatment for ischemic stroke. N Engl J Med. 2013;368:914–23.CrossRefPubMedPubMedCentral
14.
Liebeskind DS, Jahan R, Nogueira RG, Zaidat OO, Saver JL, SWIFT Investigators. Impact of collaterals on successful revascularization in solitaire FR with the intention for thrombectomy. Stroke. 2014;45:2036–40.CrossRefPubMedPubMedCentral
15.
Lima FO, Furie KL, Silva GS, Lev MH, Camargo EC, Singhal AB, et al. The pattern of leptomeningeal collaterals on CT angiography is a strong predictor of long-term functional outcome in stroke patients with large vessel intracranial occlusion. Stroke. 2010;41:2316–22.
16.
Bang OY, Saver JL, Kim SJ, Kim GM, Chung CS, Ovbiagele B, et al. Collateral flow predicts response to endovascular therapy for acute ischemic stroke. Stroke. 2011;42:693–9.CrossRefPubMedPubMedCentral
17.
18.
Marks MP, Lansberg MG, Mlynash M, Olivot JM, Straka M, Kemp S, et al. Diffusion and perfusion imaging evaluation for understanding stroke evolution 2 investigators. Effect of collateral blood flow on patients undergoing endovascular therapy for acute ischemic stroke. Stroke. 2014;45:1035–9.CrossRefPubMedPubMedCentral
19.
Bang OY, Saver JL, Buck BH, Alger JR, Starkman S, Ovbiagele B, et al. Impact of collateral flow on tissue fate in acute ischaemic stroke. J Neurol Neurosurg Psychiatry. 2008;79:625–9.CrossRefPubMed
20.
Campbell BC, Christensen S, Tress BM, Churilov L, Desmond PM, Parsons MW, et al. Failure of collateral blood flow is associated with infarct growth in ischemic stroke. J Cereb Blood Flow Metab. 2013;33:1168–72.CrossRefPubMedPubMedCentral
21.
Bang OY, Saver JL, Kim SJ, Kim GM, Chung CS, Ovbiagele B, et al. Collateral flow averts hemorrhagic transformation after endovascular therapy for acute ischemic stroke. Stroke. 2011;42:2235–9.CrossRefPubMed
22.
Brozici M, van der Zwan A, Hillen B. Anatomy and functionality of leptomeningieal anastomoses: a review. Stroke. 2003;34:2750–62.CrossRefPubMed
23.
Shuaib A, Butcher K, Mohammad AA, Saqqur M, Liebeskind DS. Collateral blood vessels in acute ischaemic stroke: a potential therapeutic target. Lancet Neurol. 2011;10:909–21.CrossRefPubMed
24.
Zhang H, Prabhakar P, Sealock R, Faber JE. Wide genetic variation in the native pial collateral circulation is a major determinant of variation in severity of stroke. J Cereb Blood Flow Metab. 2010;30:923–34.CrossRefPubMedPubMedCentral
25.
Chan S-L, Sweet JG, Bishop N, Cipolla MJ. Pial collateral reactivity during hypertension and aging: understanding the function of collaterals for stroke therapy. Stroke. 2016.
26.
Hedera P, Bujdáková J, Traubner P, Pancák J. Stroke risk factors and development of collateral flow in carotid occlusive disease. Acta Neurol Scand. 1998;98:182–6.CrossRefPubMed
27.
Letourneur A, Roussel S, Toutain J, Bernaudin M, Touzani O. Impact of genetic and renovascular chronic arterial hypertension on the acute spatiotemporal evolution of the ischemic penumbra: a sequential study with MRI in the rat. J Cereb Blood Flow Metab. 2011;31:504–13.CrossRefPubMed
28.
McCabe C, Gallagher L, Gsell W, Graham D, Dominiczak AF, Macrae IM. Differences in the evolution of the ischemic penumbra in stroke-prone spontaneously hypertensive and Wistar-Kyoto rats. Stroke. 2009;40:3864–8.CrossRefPubMedPubMedCentral
29.
Satoh K, Fukumoto Y, Shimokawa H. Rho-kinase: important new therapeutic target in cardiovascular diseases. Am J Physiol Heart Circ Physiol. 2011;301:H287–96.CrossRefPubMed
30.
Faraci FM, Lamping KG, Modrick ML, Ryan MJ, Sigmund CD, Didion SP. Cerebral vascular effects of angiotensin II: new insights from genetic models. J Cereb Blood Flow Metab. 2006;26:449–55.CrossRefPubMed
31.
Davies SP, Reddy H, Caivano M, Cohen P. Specificity and mechanism of action of some commonly used protein kinase inhibitors. Biochem J. 2000;351:95–105.CrossRefPubMedPubMedCentral
32.
Laufs U, Endres M, Stagliano N, Amin-Hanjani S, Chui DS, Yang SX, et al. Neuroprotection mediated by changes in the endothelial actin cytoskeleton. J Clin Invest. 2000;106:15–24.CrossRefPubMedPubMedCentral
33.
Nishikawa Y, Doi M, Koji T, Watanabe M, Kimura S, Kawasaki S, et al. The role of rho and rho-dependent kinase in serotonin-induced contraction observed in bovine middle cerebral artery. Tohoku J Exp Med. 2003;201:239–49.CrossRefPubMed
34.
Shin HK, Huang PL, Ayata C. Rho-kinase inhibition improves ischemic perfusion deficit in hyperlipidemic mice. J Cereb Blood Flow Metab. 2014;34:284–7.CrossRefPubMed
35.
Shin HK, Salomone S, Potts EM, Lee SW, Millican E, Noma K, et al. Rho-kinase inhibition acutely augments blood flow in focal cerebral ischemia via endothelial mechanisms. J Cereb Blood Flow Metab. 2007;27:998–1009.PubMed
36.
37.
Wu J, Li J, Hu H, Liu P, Fang Y, Wu D. Rho-kinase inhibitor, fasudil, prevents neuronal apoptosis via the Akt activation and PTEN inactivation in the ischemic penumbra of rat brain. Cell Mol Neurobiol. 2012;32:1187–97.CrossRefPubMed
38.
Ishiguro M, Kawasaki K, Suzuki Y, Ishizuka F, Mishiro K, Egashira Y, et al. A Rho kinase (ROCK) inhibitor, fasudil, prevents matrix metalloproteinase-9-related hemorrhagic transformation in mice treated with tissue plasminogen activator. Neuroscience. 2012;220:302–12.CrossRefPubMed
39.
Lee JH, Zheng Y, von Bornstadt D, Wei Y, Balcioglu A, Daneshmand A, et al. Selective ROCK2 inhibition in focal cerebral ischemia. Ann Clin Transl Neurol. 2014;1:2–14.CrossRefPubMed
40.
Gibson CL, Srivastava K, Sprigg N, Bath PMW, Bayraktutan U. Inhibition of Rho-kinase protects cerebral barrier from ischaemia-evoked injury through modulations of endothelial cell oxidative stress and tight junctions. J Neurochem. 2014;129:816–26.CrossRefPubMed
41.
Gokina N, Park KM, McElroy-Yaggy K, Osol G. Effects of Rho kinase inhibition on cerebral artery myogenic tone and reactivity. J Appl Physiol (1985). 2005;98:1940–8.CrossRef
42.
Ledoux J, Werner ME, Brayden JE, Nelson MT. Calcium-activated potassium channels and the regulation of vascular tone. Physiology. 2006;21:69–79.
43.
Marrelli SP, Eckmann MS, Hunte MS. Role of endothelial intermediate conductance Kca channels in cerebral EDHF-mediated dilations. Am J Physiol. 2003;285:H1590–9.
44.
Cipolla MJ, Smith J, Kohlmeyer MM, Godfrey JA. SKCa and IKCa Channels, myogenic tone, and vasodilator responses in middle cerebral arteries and parenchymal arterioles: effect of ischemia and reperfusion. Stroke. 2009;40:1451–7.CrossRefPubMedPubMedCentral
45.
Mishra RC, Belke D, Wulff H, Braun AP. SKA-31, a novel activator of SK(Ca) and IK(Ca) channels, increases coronary flow in male and female rat hearts. Cardiovasc Res. 2013;97:339–48.CrossRefPubMed
46.
An H, Ford AL, Vo K, Eldeniz C, Ponisio R, Zhu H, et al. Early changes of tissue perfusion after tissue plasminogen activator in hyperacute ischemic stroke. Stroke. 2011;2:65–72.CrossRef
47.
Soares BP, Tong E, Hom J, Cheng SC, Bredno J, Boussel L, et al. Reperfusion is a more accurate predictor of follow-up infarct volume than recanalization: a proof of concept using CT in acute ischemic stroke patients. Stroke. 2010;41:e34–40.CrossRefPubMed
48.
Busch E, Krüger K, Allegrini PR, Kerskens CM, Gyngell ML, Hoehn-Berlage M, et al. Reperfusion after thrombolytic therapy of embolic stroke in the rat: magnetic resonance and biochemical imaging. J Cereb Blood Flow Metab. 1998;18:407–18.CrossRefPubMed
49.
Garcia JH, Liu KF, Yoshida Y, Chen S, Lian J. Brain microvessels: factors altering their patency after the occlusion of a middle cerebral artery (Wistar rat). Am J Pathol. 1994;145:728–40.PubMedPubMedCentral
50.
del Zoppo GJ, Mabuchi T. Cerebral microvessel responses to focal ischemia. J Cereb Blood Flow Metab. 2003;23:879–94.CrossRefPubMed
51.
del Zoppo GJ, Poeck K, Pessin MS, Wolpert SM, Furlan AJ, Ferbert A, et al. Recombinant tissue plasminogen activator in acute thrombotic and embolic stroke. Ann Neurol. 1992;32:78–86.CrossRefPubMed
52.
Alexandrov AV, Molina CA, Grotta JC, Garami Z, Ford SR, Alvarez-Sabin J, et al. Ultrasound-enhanced systemic thrombolysis for acute ischemic stroke. N Engl J Med. 2004;351:2170–8.CrossRefPubMed
53.
Ribo M, Alvarez-Sabin J, Montaner J, Romero F, Delgado P, Rubiera M, et al. Temporal profile of recanalization after intravenous tissue plasminogen activator: selecting patients for rescue reperfusion techniques. Stroke. 2006;37:1000–4.CrossRefPubMed
54.
Lee KY, Han SW, Kim SH, Nam HS, Ahn SW, Kim DJ, et al. Early recanalization after intravenous administration of recombinant tissue plasminogen activator as assessed by pre- and post-thrombolytic angiography in acute ischemic stroke patients. Stroke. 2007;38:192–3.CrossRefPubMed
55.
Kimura K, Iguchi Y, Shibazaki K, Aoki J, Uemura J. Early recanalization rate of major occluded brain arteries after intravenous tissue plasminogen activator therapy using serial magnetic resonance angiography studies. Eur Neurol. 2009;62:287–92.CrossRefPubMed
56.
Vanacker P, Lambrou D, Eskandari A, Maeder P, Meuli R, Ntaios G, et al. Improving prediction of recanalization in acute large vessel occlusive Stroke. J Thromb Haemost. 2014;12:814–21.CrossRefPubMed
57.
Alexandrov AV, Hall CE, Labiche LA, Wojner AW, Grotta JC. Ischemic stunning of the brain: early recanalization without immediate clinical improvement in acute ischemic stroke. Stroke. 2004;35:449–52.CrossRefPubMed
58.
del Zoppo GJ, Schmid-Schönbein GW, Mori E, Copeland BR, Chang CM. Polymorphonuclear leukocytes occlude capillaries following middle cerebral artery occlusion and reperfusion in baboons. Stroke. 1991;22:1276–83.CrossRefPubMed
59.
Hallenbeck JM, Dutka AJ, Tanishima T, Kochanek PM, Kumaroo KK, Thompson CB, et al. Polymorphonuclear leukocyte accumulation in brain regions with low blood flow during the early postischemic period. Stroke. 1986;17:246–53.CrossRefPubMed
60.
Faraci FM, Mayhan WG, Heistad DD. Segmental vascular responses to acute hypertension in cerebrum and brain stem. Am J Physiol. 1987;252:H738–42.PubMed
61.
Faraci FM, Heistad DD. Regulation of large cerebral arteries and cerebral microvascular pressure. Circ Res. 1990;66:8–17.CrossRefPubMed
62.
Faraci FM, Mayhan WG, Schmid PG, Heistad DD. Effects of arginine vasopressin on cerebral microvascular pressure. Am J Physiol. 1988;255:H70–6.PubMed
63.
Cipolla MJ, Chan SL, Sweet J, Tavares MJ, Gokina N, Brayden JE. Postischemic reperfusion causes smooth muscle calcium sensitization and vasoconstriction of parenchymal arterioles. Stroke. 2014;45:2425–30.CrossRefPubMedPubMedCentral
64.
Cipolla MJ, Sweet J, Chan SL, Tavares MJ, Gokina N, Brayden JE. Increased pressure-induced tone in rat parenchymal arterioles vs. middle cerebral arteries: role of ion channels and calcium sensitivity. J Appl Physiol (1985). 2014;117:53–9.CrossRef
65.
Baumbach GL, Heistad DD. Regional, segmental, and temporal heterogeneity of cerebral vascular autoregulation. Ann Biomed Eng. 1985;13:303–10.CrossRefPubMed
66.
Baumbach GL, Mayhan WG, Heistad DD. Protection of the blood–brain barrier by hypercapnia during acute hypertension. Am J Physiol. 1986;251:H282–7.PubMed
67.
Ronaldson PT, Davis TP. Blood–brain barrier integrity and glial support: mechanisms that can be targeted for novel therapeutic approaches in stroke. Curr Pharm Des. 2012;18:3624–44.CrossRefPubMedPubMedCentral
68.
Ergul A, Kelly-Cobbs A, Abdalla M, Fagan SC. Cerebrovascular complications of diabetes: focus on stroke. Endocr Metab Immune Disord Drug Targets. 2012;12(2):148–58.CrossRefPubMedPubMedCentral
69.
Cipolla MJ, Huang Q, Sweet JG. Inhibition of protein kinase Cβ reverses increased blood–brain barrier permeability during hyperglycemic stroke and prevents edema formation in vivo. Stroke. 2011;42:3252–7.CrossRefPubMedPubMedCentral
70.
Kumai Y, Ooboshi H, Ibayashi S, Ishikawa E, Sugimori H, Kamouchi M, et al. Postischemic gene transfer of soluble Flt-1 protects against brain ischemia with marked attenuation of blood–brain barrier permeability. J Cereb Blood Flow Metab. 2007;27(6):1152–60.CrossRefPubMed
71.
Lyden PD. Hemorrhagic transformation during thrombolytic therapy and reperfusion: effects of age, blood pressure, and matrix metalloproteinases. J Stroke Cerebrovasc Dis. 2013;22(4):532–8.CrossRefPubMed
72.
Wang M, Joshi S, Emerson RG. Comparison of intracarotid and intravenous propofol for electrocerebral silence in rabbits. Anesthesiology. 2003;99:904–10.CrossRefPubMed
73.
Yamashita J, Handa H, Tokuriki Y, Ha YS, Otsuka SI, Suda K, et al. Intra-arterial ACNU therapy for malignant brain tumors. Experimental studies and preliminary clinical results. J Neurosurg. 1983;59:424–30.CrossRefPubMed
74.
Joshi S, Young WL, Pile-Spellman J, Duong DH, Vang MC, Hacein-Bey L, et al. The feasibility of intracarotid adenosine for the manipulation of human cerebrovascular resistance. Anesth Analg. 1998;87:1291–8.PubMed
75.
76.
Chen H, Yoshioka H, Kim GS, Jung JE, Okami N, Sakata H, et al. Oxidative stress in ischemic brain damage: mechanisms of cell death and potential molecular targets for neuroprotection. Antioxid Redox Signal. 2011;14:1505–17.CrossRefPubMedPubMedCentral
77.
Duong H, Hacein-Bey L, Vang MC, Pile-Spellman J, Joshi S, Young WL. Management of cerebral arterial occlusion during endovascular treatment of cerebrovascular disease. Problems in Anesthesia. 1997;9:99–111.
78.
Hillen B. The variability of the circle of Willis: univariate and bivariate analysis. Acta Morphol Neerl Scand. 1986;24:87–101.PubMed
79.
Hillen B, Hoogstraten HW, Van Overbeeke JJ, Van der Zwan A. Functional anatomy of the circulus arteriosus cerebri (WillisII). Bull Assoc Anat. 1991;75:123–6.
80.
Hillen B, Drinkenburg BA, Hoogstraten HW, Post L. Analysis of flow and vascular resistance in a model of the circle of Willis. J Biomechan. 1988;21:807–14.CrossRef
81.
Dedrick RL. Arterial drug infusion: pharmacokinetic problems and pitfalls. J Natl Cancer Inst. 1988;80:84–9.CrossRefPubMed
82.
Cipolla MJ. The cerebral circulation. In: Integrated systems physiology—from molecule to function. Morgan & Claypool Life Sciences Publishers:San Rafael, 2009
83.
Butt AM. Effect of inflammatory agents on electrical resistance across the blood–brain barrier in pial microvessels of anaesthetized rats. Brain Res. 1995;696:145–50.CrossRefPubMed
84.
Giraud M, Cho TH, Nighoghossian N, Maucort-Boulch D, Deiana G, Østergaard L, et al. Early blood brain barrier changes in acute ischemic stroke: a sequential MRI study. J Neuroimaging. 2015;25:959–63.CrossRefPubMed
85.
Prasad S, Sajja RK, Naik P, Cucullo L. Diabetes mellitus and blood–brain barrier dysfunction: an overview. J Pharmacovigil. 2014;2:125.PubMedPubMedCentral
86.
Won SJ, Tang XN, Suh SW, Yenari MA, Swanson RA. Hyperglycemia promotes tissue plasminogen activator-induced hemorrhage by increasing superoxide production. Ann Neurol. 2011;70:583–90.CrossRefPubMedPubMedCentral
87.
88.
Obrist WD, Thompson Jr HK, Wang HS, Wilkinson WE. Regional cerebral blood flow estimated by 133xenon inhalation. Stroke. 1975;6:245–56.CrossRefPubMed
89.
Obrist WD, Dolinskas CA, Jaggi JL, Cruz J, Steiman DL. Serial cerebral blood flow studies in acute head injury: application of the intravenous 133 Xe method. 1983. p. 145–50.
90.
Sanelli PC, Nicola G, Tsiouris AJ, Ougorets I, Knight C, Frommer B, et al. Reproducibility of post processing of quantitative CT perfusion maps. AJR Am J Roentgenol. 2007;188:213–8.CrossRefPubMed
91.
Morales Palomares S, Cipolla MJ. Vascular protection following ischemia and reperfusion. J Neurol Neurophysiol. 2011;20:S1–4.
92.
Cipolla MJ, McCall A, Lessov N, Porter J. Reperfusion decreases myogenic reactivity and alters middle cerebral artery function after focal cerebral ischemia in rats. Stroke. 1997;28:176–80.CrossRefPubMed
93.
Linfante I, Walker GR, Castonguay AC, Dabus G, Starosciak AK, Yoo AJ, et al. Predictors of mortality in acute ischemic stroke intervention: analysis of the north American solitaire acute stroke registry. Stroke. 2015;46:2305–8.CrossRefPubMed
94.
Linfante I, Starosciak AK, Walker GR, Dabus G, Castonguay AC, Gupta R, et al. Predictors of poor outcome despite recanalization: a multiple regression analysis of the NASA registry. J NeuroIntervent Surg. 2015;8(3):1–6. doi:10.​1136/​neurintsurg-2014-011525.
95.
Wardlaw JM, Murray V, Berge E, del Zoppo G, Sandercock P, Lindley RL, et al. Recombinant tissue plasminogen activator for acute ischaemic stroke:an updated systematic review and meta-analysis. Lancet. 2012;379:2364–72.
96.
Saver JL, Fonarow GC, Smith EE, Reeves MJ, Grau-Sepulveda MV, Pan W, et al. Time to treatment with intravenous plasminogen activator and outcome from acute ischemic stroke. JAMA. 2013;309:2480–8.
97.
Broderick JP, Palesch YY, Demchuk AM, Yeatts SD, Khatri P, Hill MD, et al. Endovascular therapy after intravenous t-PA versus t-PA alone for stroke. N Engl J Med. 2013;368:893–903.
98.
Hussein HM, Georgiadis AL, Vazquez G, Miley JT, Memon MZ, Mohammad YM, et al. Occurrence and predictorsof futile recanalization following endovascular treatment among patients with acute ischemic stroke. AJNR Am J Neuroradiol. 2010;31:454–458.
Metadata
Title
Improving Reperfusion Therapies in the Era of Mechanical Thrombectomy
Authors
Italo Linfante
Marilyn J. Cipolla
Publication date
01-08-2016
Publisher
Springer US
Published in
Translational Stroke Research / Issue 4/2016
Print ISSN: 1868-4483
Electronic ISSN: 1868-601X
DOI
https://doi.org/10.1007/s12975-016-0469-3

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