Micro-Embolic Events and Their Clearing in the Brain. A Narrative Review

IF 5.6 2区医学 Q1 PHYSIOLOGY

Acta Physiologica Pub Date : 2025-09-10 DOI:10.1111/apha.70098

Kevin Mol, Inge A. Mulder, Ed van Bavel

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Abstract

Background

The cerebral circulation is continuously challenged by intravascular micrometer-sized particles that become trapped microvascular-emboli. These particles may include micro-thrombi, stiffened erythrocytes, and leukocytes, while also fat particles, air, and microplastics may cause microvascular embolism.

Review Scope

In this narrative review, we discuss these embolization processes and their acute and chronic consequences. These relate to the local flow interruption as well as the direct interaction with the endothelium. In addition, we address the clearing processes, including local thrombolysis and extravasation, or angiophagy, of the emboli.

Conclusion

A continuous balance exists between embolic events and their resolution under normal conditions. Increased micro-embolic rates, as occur in e.g., atrial fibrillation, or decreased clearing, possibly related to endothelial cell dysfunction, disturb this balance. This could lead to continuing loss of capillaries, micro-infarcts, and cognitive decline.

Abstract Image

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脑内微栓塞事件及其清除。叙述性回顾

脑循环不断受到血管内微米大小的颗粒的挑战，这些颗粒被困在微血管栓塞中。这些颗粒可能包括微血栓、硬化的红细胞和白细胞，同时脂肪颗粒、空气和微塑料也可能引起微血管栓塞。在这篇叙述性综述中，我们讨论这些栓塞过程及其急性和慢性后果。这些与局部血流中断以及与内皮细胞的直接相互作用有关。此外，我们解决清除过程，包括局部溶栓和外渗，或血管吞噬，栓子。结论在正常情况下，栓子事件与其消退之间存在连续的平衡。微栓塞率增加，如房颤，或清除率降低，可能与内皮细胞功能障碍有关，破坏了这种平衡。这可能导致持续的毛细血管丧失、微梗死和认知能力下降。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Acta Physiologica 医学-生理学

CiteScore

11.80

自引率

15.90%

发文量

182

审稿时长

4-8 weeks

期刊介绍： Acta Physiologica is an important forum for the publication of high quality original research in physiology and related areas by authors from all over the world. Acta Physiologica is a leading journal in human/translational physiology while promoting all aspects of the science of physiology. The journal publishes full length original articles on important new observations as well as reviews and commentaries.