Gupta Rishi, Jovin Tudor G
Michigan State University, Department of Neurology, Division of Cerebrovascular Diseases, East Lansing, MI 48824, USA.
Expert Rev Neurother. 2007 Feb;7(2):143-53. doi: 10.1586/14737175.7.2.143.
Selection of patients for acute-stroke therapy has traditionally been based on rigid time criteria in clinical trials. Recent advances in radiographic imaging have allowed clinicians to estimate brain physiology and thus utilize radiographic parameters to select patients for acute-stroke therapies. Both a better understanding and the quantification methods of salvageable tissue versus irreversibly injured tissue can help guide clinicians to which treatment modality to utilize. The evolution of endovascular techniques to treat acute stroke has resulted in treatment modalities that include mechanical and chemical methods to revascularize occluded cerebral arteries. Prior technical limitations to accessing distal-cerebral arteries have been partially overcome by modifications in technology. Patient and treatment-modality selection can help reduce hemorrhagic complication rates and also potentially increase revascularization rates, which may translate into improved clinical outcomes. We review the recent advances in radiographic imaging that have advanced patient selection in treating acute ischemic stroke and also consider current endovascular treatment options that are available to interventionalists performing these procedures.
传统上，急性中风治疗患者的选择是基于临床试验中的严格时间标准。放射影像学的最新进展使临床医生能够评估脑生理状况，从而利用放射学参数来选择急性中风治疗的患者。对可挽救组织与不可逆损伤组织的更好理解及其量化方法，有助于指导临床医生选择使用哪种治疗方式。治疗急性中风的血管内技术的发展，产生了包括机械和化学方法使闭塞脑动脉再通的治疗方式。技术上的改进部分克服了以往进入大脑远端动脉的限制。患者和治疗方式的选择有助于降低出血并发症发生率，还可能提高再通率，这可能转化为更好的临床结果。我们回顾了放射影像学的最新进展，这些进展推动了急性缺血性中风治疗中患者的选择，同时也考虑了进行这些手术的介入医生目前可用的血管内治疗选择。
