Neurovascular Unit, Department of Neuroscience, Hospital Universitari Vall d'Hebron, Passeig Vall d'Hebron 119-129, 08035 Barcelona, Spain.
Stroke. 2011 Jan;42(1 Suppl):S16-9. doi: 10.1161/STROKEAHA.110.598763. Epub 2010 Dec 16.
Arterial recanalization and subsequent reperfusion have extensively demonstrated their ability to restore the brain function when performed shortly after acute ischemic stroke. However, arterial recanalization does not necessarily lead to brain tissue reperfusion.
This review provides an update of current approaches to improve the efficacy profile of brain tissue reperfusion within and beyond the therapeutic window, including the use of novel thrombolytic agents, bridging intravenous and intra-arterial therapies, and mechanical clot retrieval or aspiration.
There are still several challenges in the near future of reperfusion therapy for acute ischemic stroke, such as improving the ultra-early access to treatment within the "golden hour," extending the therapeutic window beyond the current 4.5-hour time window, and developing novel thrombolitics or combined approaches to improve treatment efficacy.
急性缺血性脑卒中发生后短时间内进行血管再通和随后的再灌注，已广泛证明其具有恢复脑功能的能力。然而，血管再通并不一定能导致脑组织再灌注。
本文综述了目前改善治疗窗内和治疗窗外脑组织再灌注效果的方法，包括使用新型溶栓药物、桥接静脉内和动脉内治疗，以及机械取栓或抽吸。
急性缺血性脑卒中再灌注治疗的近期仍存在一些挑战，如提高“黄金时间”内的超早期治疗机会、将治疗窗扩展至目前 4.5 小时时间窗以外，以及开发新型溶栓药物或联合治疗方法以提高治疗效果。
