Research Trends and Hotspots of Collateral Circulation in Acute Ischemic Stroke: A Bibliometric Analysis.

Abstract

IntroductionCollateral circulation is a critical determinant of outcomes in acute ischemic stroke (AIS). This bibliometric analysis evaluates research trends and future directions on this topic.MethodsA systematic search was conducted in the Web of Science Core Collection to identify publications on AIS and collateral circulation between 1981 and 2025. Bibliometric analysis and visualization were performed using VOSviewer, CiteSpace, and the R package "bibliometric."ResultsThe analysis included 482 publications. China was the most productive countries, leading in publication volume (642). The University of California System emerged as top contributing institutions. <i>Stroke</i> was the most influential journals in terms of H-index (33), TP (53), and TC (3796). David S. Liebeskind and Gregory W. Albers were identified as leading authors. Keyword co-occurrence and cluster analysis revealed four main thematic areas: imaging and diagnostic assessment, treatment strategies, prognosis and outcome prediction, and pathophysiological mechanisms and hemodynamics. In addition, burst keyword analysis showed that terms like "large vessel occlusion", "score", "management", and "endovascular thrombectomy" remained active through 2025.ConclusionResearch on collateral circulation in AIS has evolved from exploring basic mechanisms to focusing on clinical applications. The current landscape integrates imaging-based collateral assessment with treatment decisions and prognosis to guide precise endovascular therapy. Future research will likely concentrate on collateral-guided precision treatment, imaging scores, and strategies for extending the therapeutic window. This study provides a comprehensive overview and valuable insights for researchers.