Recent studies suggest that advances in medical therapy have reduced the risk of stroke in patients with major cerebral artery disease, but does this trend apply to those with misery perfusion? A new study indicates that these patients remain at very high risk, highlighting the unmet need for a preventative treatment.
This is a preview of subscription content, access via your institution
Access options
Subscribe to this journal
Receive 12 print issues and online access
$209.00 per year
only $17.42 per issue
Buy this article
- Purchase on Springer Link
- Instant access to full article PDF
Prices may be subject to local taxes which are calculated during checkout
References
Grubb, R. L. Jr et al. Importance of hemodynamic factors in the prognosis of symptomatic carotid occlusion. JAMA 280, 1055–1060 (1998).
Yamauchi, H. et al. Significance of increased oxygen extraction fraction in five-year prognosis of major cerebral arterial occlusive diseases. J. Nucl. Med. 40, 1992–1998 (1999).
Marquardt, L., Geraghty, O. C., Mehta, Z. & Rothwell, P. M. Low risk of ipsilateral stroke in patients with asymptomatic carotid stenosis on best medical treatment: a prospective, population-based study. Stroke 41, e11–e17 (2010).
Yamauchi, H. et al. Is misery perfusion still a predictor of stroke in symptomatic major cerebral artery disease? Brain http://dx.doi.org/10.1093/brain/aws131.
Powers, W. J. et al. Extracranial–intracranial bypass surgery for stroke prevention in hemodynamic cerebral ischemia: the Carotid Occlusion Surgery Study randomized trial. JAMA 306, 1983–1992 (2011).
[No authors listed]. Failure of extracranial–intracranial arterial bypass to reduce the risk of ischemic stroke. Results of an international randomized trial. The EC–IC Bypass Study Group. N. Engl. J. Med. 313, 1191–1200 (1985).
Powers, W. J. et al. Improving prognosis of medically treated hemodynamic cerebral ischemia is associated with more lipid lowering therapy [abstract S12.001]. Presented at the 63rd Meeting of the American Academy of Neurology, Honolulu, HI, 2011.
Marshall, R. S. et al. Cerebral hemodynamics and cognitive impairment: baseline data from the RECON trial. Neurology 78, 250–255 (2012).
JET Study Group. Japanese EC–IC Bypass Trial (JET Study): the second interim analysis. Surg. Cereb. Stroke 30, 434–437 (2002).
Powers, W. J. Management of patients with atherosclerotic carotid occlusion. Curr. Treat. Options Neurol. 13, 608–615 (2011).
Author information
Authors and Affiliations
Ethics declarations
Competing interests
The author declares no competing financial interests.
Rights and permissions
About this article
Cite this article
Powers, W. Misery perfusion in cerebrovascular disease—is it important?. Nat Rev Neurol 8, 479–480 (2012). https://doi.org/10.1038/nrneurol.2012.147
Published:
Issue Date:
DOI: https://doi.org/10.1038/nrneurol.2012.147