Department of Neurology, SUNY Upstate Medical University, Syracuse, New York, USA.
Ann N Y Acad Sci. 2012 Sep;1268:134-40. doi: 10.1111/j.1749-6632.2012.06753.x.
Treatment of acute ischemic stroke (AIS) is an evolving field. New treatment options are still needed in order to achieve greater success rates for arterial recanalization. Intra-arterial therapy (lAT) is an option for AIS patients who are not good candidates for intravenous (i.v.) recombinant tissue plasminogen activator (rt-PA) or where it has failed. While good data establishing the role of IAT in AIS management are lacking, the potential clinical efficacy of IAT is based on the premise that recanalization and reperfusion may result in better clinical outcome. Although lAT recanalization and reperfusion rates of large vessel occlusion are much higher than they are for i.v. rt-PA, IAT's radiological efficacy is still far from perfect. Vasodilator use during IAT for AIS may increase the recanalization and reperfusion rates of such therapy. In this report, we describe the radiographic and clinical outcomes in a cohort of AIS patients who received intra-arterial (i.a.) vasodilators during IAT and summarize the role of i.a. vasodilators in the process of recanalization and reperfusion.
急性缺血性脑卒中(AIS)的治疗是一个不断发展的领域。为了提高动脉再通率,仍需要新的治疗选择。对于不适合静脉(i.v.)重组组织型纤溶酶原激活剂(rt-PA)或该药物治疗失败的 AIS 患者,动脉内治疗(IAT)是一种选择。尽管缺乏确立 IAT 在 AIS 管理中作用的良好数据,但 IAT 的潜在临床疗效基于这样的前提,即再通和再灌注可能导致更好的临床结果。尽管 IAT 治疗大血管闭塞的再通和再灌注率远高于 i.v. rt-PA,但 IAT 的放射学疗效仍远非完美。在 AIS 的 IAT 中使用血管扩张剂可能会增加这种治疗的再通和再灌注率。在本报告中,我们描述了接受 IAT 中 i.a.血管扩张剂治疗的 AIS 患者的影像学和临床结局,并总结了 i.a.血管扩张剂在再通和再灌注过程中的作用。