Reperfusion therapy in acute ischemic stroke: dawn of a new era?

被引：232

作者：

Bhaskar, Sonu ^{[1
,2
,3
,4
,6
,7
,8
]}

Stanwell, Peter ^{[7
,8
]}

Cordato, Dennis ^{[2
,4
,5
]}

Attia, John ^{[7
,8
,9
]}

Levi, Christopher ^{[1
,2
,3
,4
,5
,6
]}

机构：

[1] WSU, Sch Med, South West Sydney Clin Sch, Sydney, NSW 2170, Australia

[2] Liverpool Hosp, Dept Neurol & Neurophysiol, Liverpool, NSW 2170, Australia

[3] SPHERE, Liverpool, NSW, Australia

[4] Ingham Inst Appl Med Res, Stroke & Neurol Res Grp, 1 Campbell St, Liverpool, NSW 2170, Australia

[5] UNSW, Sch Med, Sydney, NSW, Australia

[6] John Hunter Hosp, Dept Neurol, Newcastle, NSW, Australia

[7] Univ Newcastle, HMRI, Fac Hlth & Med, Prior Res Ctr Stroke & Brain Injury, Newcastle, NSW, Australia

[8] Univ Newcastle, Sch Med & Publ Hlth, Newcastle, NSW, Australia

[9] Univ Newcastle, Hunter Med Res Inst, Ctr Clin Epidemiol & Biostat, Newcastle, NSW, Australia

来源：

BMC NEUROLOGY | 2018年 / 18卷

基金：

英国医学研究理事会;

关键词：

Stroke; Reperfusion therapy; Prognosis; Endovascular treatment; Neurointervention; TISSUE-PLASMINOGEN-ACTIVATOR; INTERNAL CAROTID-ARTERY; GLYCOPROTEIN-IIB/IIIA INHIBITION; INDIVIDUAL PATIENT DATA; ENDOVASCULAR MECHANICAL THROMBECTOMY; TRANSCRANIAL DOPPLER PREDICTS; STENT-RETRIEVER THROMBECTOMY; REDUCED FIBRINOLYTIC THERAPY; ANTERIOR CIRCULATION STROKE; ACUTE MYOCARDIAL-INFARCTION;

D O I：

10.1186/s12883-017-1007-y

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

100204 [神经病学];

摘要：

Following the success of recent endovascular trials, endovascular therapy has emerged as an exciting addition to the arsenal of clinical management of patients with acute ischemic stroke (AIS). In this paper, we present an extensive overview of intravenous and endovascular reperfusion strategies, recent advances in AIS neurointervention, limitations of various treatment paradigms, and provide insights on imaging-guided reperfusion therapies. A roadmap for imaging-guided reperfusion treatment workflow in AIS is also proposed. Both systemic thrombolysis and endovascular treatment have been incorporated into the standard of care in stroke therapy. Further research on advanced imaging-based approaches to select appropriate patients, may widen the time-window for patient selection and would contribute immensely to early thrombolytic strategies, better recanalization rates, and improved clinical outcomes.

引用

页数：26

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