Stroke unit, Sainte-Anne hospital, 1, rue Cabanis, 75014 Paris, France; Université Paris Descartes, Sorbonne Paris Cité, France; Inserm UMR S894, France.
Stroke unit, Sainte-Anne hospital, 1, rue Cabanis, 75014 Paris, France; Université Paris Descartes, Sorbonne Paris Cité, France.
Diagn Interv Imaging. 2014 Dec;95(12):1129-33. doi: 10.1016/j.diii.2014.10.002. Epub 2014 Nov 15.
Intravenous thrombolysis (IVT) with alteplase remains the standard treatment for acute ischemic stroke. Although IVT can be started up to 4.5 hours after symptoms' onset, it is all the more effective and safe when started early. It allows a 10% absolute reduction in the risk of handicap or death at 3 months, despite a 2-7% risk of symptomatic intracranial hemorrhage. Current research efforts involve firstly trying to treat a larger proportion of patients by overcoming some of the contraindications to IVT and secondly assessing combined or alternative treatments to achieve a higher early recanalization rate.
静脉溶栓（IVT）联合阿替普酶仍然是急性缺血性脑卒中的标准治疗方法。尽管 IVT 可以在症状发作后 4.5 小时内开始，但早期开始治疗效果更好且更安全。尽管存在 2-7%的症状性颅内出血风险，但 IVT 治疗可以使 3 个月时残疾或死亡的风险降低 10%。目前的研究工作首先涉及通过克服 IVT 的一些禁忌证来尝试治疗更大比例的患者，其次评估联合或替代治疗以实现更高的早期再通率。
