Department of Neurology, UCLA, 710 Westwood Plaza, Los Angeles, CA 90095, USA.
Expert Opin Pharmacother. 2011 Apr;12(6):913-30. doi: 10.1517/14656566.2011.543897. Epub 2011 Feb 5.
Intravenous fibrinolysis is the only proven treatment for acute ischemic stroke (AIS), but a limited therapeutic time window and risk of systemic hemorrhagic limit its real-world effectiveness. Minimally invasive endovascular therapies may provide opportunities to expand the AIS treatment window and enhance clinical outcomes.
Current and future endovascular techniques that aim to address the hemodynamic, neuroanatomic and neurovascular complexities of acute cerebral ischemia are discussed. Scales for measuring relevant angiographic and clinical end points are also covered. Procedural timing and optimal patient selection using various imaging modalities are mentioned. Previous and ongoing clinical trials in AIS are discussed as well as emerging approaches.
Endovascular therapy has opened up new horizons for treatment of AIS. It offers multiple new and promising therapeutic approaches that are not limited to one specific device or method, but could conceivably be additive and also individualized based upon each patient's characteristics.
静脉溶栓是治疗急性缺血性脑卒中（AIS）的唯一有效方法，但治疗时间窗有限且存在全身出血风险，限制了其在实际中的效果。微创血管内治疗可能为扩大 AIS 治疗时间窗和提高临床疗效提供机会。
本文讨论了旨在解决急性脑缺血血流动力学、神经解剖和神经血管复杂问题的当前和未来血管内技术，并介绍了用于测量相关血管造影和临床终点的评分量表。还提到了使用各种成像方式的治疗时机和最佳患者选择，讨论了 AIS 的既往和正在进行的临床试验以及新出现的方法。
血管内治疗为 AIS 的治疗开辟了新的视野。它提供了多种新的、有前途的治疗方法，不仅限于一种特定的设备或方法，而且可以根据每个患者的特点进行补充和个体化。
