MR and CT Monitoring of Recanalization, Reperfusion, and Penumbra Salvage Everything That Recanalizes Does Not Necessarily Reperfuse!

被引：80

作者：

Soares, Bruno P. ^{[1
]}

Chien, Jeffrey D. ^{[1
]}

Wintermark, Max ^{[1
]}

机构：

[1] Univ Calif San Francisco, Dept Radiol, Neuroradiol Sect, San Francisco, CA 94143 USA

来源：

STROKE | 2009年 / 40卷 / 03期

关键词：

brain infarction; brain ischemia; cerebral infarct; CT; magnetic resonance; neuroradiology; reprefusion; tPA; ACUTE ISCHEMIC-STROKE; NO-REFLOW; DESMOTEPLASE; EFFICACY; SAFETY; TRIAL;

D O I：

10.1161/STROKEAHA.108.526814

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

Revascularization therapies for acute stroke patients aim to rescue the ischemic penumbra by restoring the patency of the occluded artery ("recanalization") and the downstream capillary blood flow ("reperfusion"). This article reviews the definition of recanalization and reperfusion used in stroke clinical trials and their limitations and proposes a study design to determine the relative importance of recanalization, reperfusion, and collateral flow in evaluating the efficacy of revascularization therapies for acute ischemic stroke. (Stroke. 2009;40[suppl 1]:S24-S27.)

引用

页码：S24 / S27

页数：4

共 18 条

[1] Magnetic resonance imaging profiles predict clinical response to early reperfusion: The diffusion and perfusion imaging evaluation for understanding stroke evolution (DEFUSE) study [J].

Albers, Gregory W. ;

Thijs, Vincent N. ;

Wechsle, Lawrence ;

Kemp, Stephanie ;

Schlaug, Gottfried ;

Skalabrin, Elaine ;

Bammer, Roland ;

Kakuda, Wataru ;

Lansberg, Maarten G. ;

Shuaib, Ashfaq ;

Coplin, William ;

Hamilton, Scott ;

Moseley, Michael ;

Marks, Michael P. .

ANNALS OF NEUROLOGY, 2006, 60 (05) :508-517

[2]

AMES A, 1968, AM J PATHOL, V52, P437

[3] Combined intravenous and intra-arterial recanalization for acute ischemic stroke: The interventional management of stroke study [J].

Broderick, J .

STROKE, 2004, 35 (04) :904-911

[4] Effects of alteplase beyond 3 h after stroke in the Echoplanar Imaging Thrombolytic Evaluation Trial (EPITHET): a placebo-controlled randomised trial [J].

Davis, Stephen M. ;

Donnan, Geoffrey A. ;

Parsons, Mark W. ;

Levi, Christopher ;

Butcher, Kenneth S. ;

Peeters, Andre ;

Barber, P. Alan ;

Bladin, Christopher ;

De Silva, Deidre A. ;

Byrnes, Graham ;

Chalk, Jonathan B. ;

Fink, John N. ;

Kimber, Thomas E. ;

Schultz, David ;

Hand, Peter J. ;

Frayne, Judith ;

Hankey, Graeme ;

Muir, Keith ;

Gerraty, Richard ;

Tress, Brian M. ;

Desmond, Patricia M. .

LANCET NEUROLOGY, 2008, 7 (04) :299-309

[5] The coronary no-reflow phenomenon: a review of mechanisms and therapies [J].

Eeckhout, E ;

Kern, MJ .

EUROPEAN HEART JOURNAL, 2001, 22 (09) :729-739

[6] Intra-arterial prourokinase for acute ischemic stroke - The PROACT II study: A randomized controlled trial [J].

Furlan, A ;

Higashida, R ;

Wechsler, L ;

Gent, M ;

Rowley, H ;

Kase, C ;

Pessin, M ;

Ahuja, A ;

Callahan, F ;

Clark, WM ;

Silver, F ;

Rivera, F .

JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 1999, 282 (21) :2003-2011

[7] Dose escalation of desmoteplase for acute ischemic stroke (DEDAS) - Evidence of safety and efficacy 3 to 9 hours after stroke onset [J].

Furlan, AJ ;

Eyding, D ;

Albers, GW ;

Al-Rawi, Y ;

Lees, KR ;

Rowley, HA ;

Sachara, C ;

Soehngen, M ;

Warach, S ;

Hacke, W .

STROKE, 2006, 37 (05) :1227-1231

[8] The Desmoteplase In Acute Ischemic Stroke Trial (DIAS) - A phase II MRI-based 9-hour window acute stroke thrombolysis trial with intravenous desmoteplase [J].

Hacke, W ;

Albers, G ;

Al-Rawi, Y ;

Bogousslavsky, J ;

Davalos, A ;

Eliasziw, M ;

Fischer, M ;

Furlan, A ;

Kaste, M ;

Lees, KR ;

Soehngen, M ;

Warach, S .

STROKE, 2005, 36 (01) :66-73

[9]

Higashida Randall, 2003, J Vasc Interv Radiol, V14, pS493

[10] Regional angiographic grading system for collateral flow - Correlation with cerebral infarction in patients with middle cerebral artery occlusion [J].

Kim, JJ ;

Fischbein, NJ ;

Lu, Y ;

Pham, D ;

Dillon, WP .

STROKE, 2004, 35 (06) :1340-1344

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