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Thus, the endovascular triage approach using advanced neuroimaging to ascertain the extent of penumbra and collateral flow status has contributed to the higher success rates seen in some trials of acute stroke intervention is triggered by hemodynamic forces such as fluid shear stress (FSS) induced by the pressure gradient during the obstruction or change of blood flow.

The collateral flow developed proximal to the occlusion does not require the local expression of HIF-1 or VEGF, although the latter is needed for the formation of collateral vessels during development and during their continuing remodeling after ischemia.

Both levels of FAK whose downstream effectors involve cell migration and FAK-activating tyrosine kinase (bone marrow tyrosine kinase, Bmx) are increased in ECs during ischemia-induced Interestingly, endothelial-specific double-knockout of two integrin isiforms, α5 and αv, does not affect developmental vasculogenesis and angiogenesis in rodents, but leads to defects in remodeling of the great vessels and heart and results in embryonic death.

Another signaling pathway, Notch cascade, is involved in arteriovenous identity in the developing vasculature.

The collateral status is also an independent predictor of outcome and response to thrombolytic therapies in patients with ischemic stroke.

Thus structural proteins of BM, laminin and collagen IV, are negative regulators of SMC proliferation, and degradation of the BM may facilitate the shift of SMC phenotype.

is defined by enlargement of small arterioles, with very low or no blood flow, to larger conducting arteries.

during mammalian vascular development the immediate precursor of vascular SMCs (VSMCs) in different arterial beds, including those that have previously been identified as neural crest– or somite-derived, is a local population of expressing immature ECs expressing tyrosine kinase with immunoglobulin-like and EGF-like domains 1 (Tie1 is the mechanical stresses of vessels.

Mechanical stresses upregulate the production of monocyte chemoattractant protein 1 (MCP-1) by ECs.

Empirical experimental evidence suggests that at least in mice, the extent of native leptomeningeal collateralization is governed by genetic factors and causally related to infarct volume in MCA stroke .

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