Background: Capillary density rarefaction and endothelial dysfunction contribute to chronic hypoperfusion and cerebral small vessel disease. Prior animal experiments revealed spatiotemporal microvascular remodelling directing post-stroke brain reorganization.

Aims: We hypothesized that microvessel perfusion changes during acute cerebrovascular events could be reflected systemically and might be associated with platelet function.

Methods: In a prospective observational trial in vivo sublingual Sidestream Darkfield videomicroscopy was performed in twenty-one patients with acute ischemic/haemorrhagic stroke or transitory ischemic attacks within twenty-four hours after hospital admission and compared to an age- and sex-matched control group. Platelet function was assessed using multiple platelet aggregometry.

Results: Functional (3060 vs 3717/mm², p=0.001) and perfused total (5263 vs 6550/mm², p=0.002) capillary density was rarefied in patients when compared to healthy controls. There were significant associations between platelet count and functional (r=0.57, p=0.007) or perfused total capillary density (r=0.52, p=0.015) as well as platelet aggregation and perfused total capillary density (thrombin receptor-activating peptide 6: r=0.57, p=0.007) or capillary density ratio (arachidonic acid: r=-0.46, p=0.037; collagen: r=-0.55, p=0.012).

Conclusions: Cerebrovascular events are associated with altered systemic microvascular perfusion. Further, microvessel perfusion correlates with platelet count and function in our patient group.

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ISTH Congress Abstracts - https://abstracts.isth.org/abstract/is-microvessel-perfusion-associated-with-platelets-in-acute-cerebrovascular-disorders/