Bhaskar Sonu, Stanwell Peter, Cordato Dennis, Attia John, Levi Christopher
Western Sydney University (WSU), School of Medicine, South West Sydney Clinical School, Sydney, NSW, 2170, Australia.
Liverpool Hospital, Department of Neurology & Neurophysiology, Liverpool, 2170, NSW, Australia.
BMC Neurol. 2018 Jan 16;18(1):8. doi: 10.1186/s12883-017-1007-y.
Following the success of recent endovascular trials, endovascular therapy has emerged as an exciting addition to the arsenal of clinical management of patients with acute ischemic stroke (AIS). In this paper, we present an extensive overview of intravenous and endovascular reperfusion strategies, recent advances in AIS neurointervention, limitations of various treatment paradigms, and provide insights on imaging-guided reperfusion therapies. A roadmap for imaging guided reperfusion treatment workflow in AIS is also proposed. Both systemic thrombolysis and endovascular treatment have been incorporated into the standard of care in stroke therapy. Further research on advanced imaging-based approaches to select appropriate patients, may widen the time-window for patient selection and would contribute immensely to early thrombolytic strategies, better recanalization rates, and improved clinical outcomes.
随着近期血管内治疗试验的成功，血管内治疗已成为急性缺血性卒中（AIS）患者临床管理手段中的一项令人振奋的补充。在本文中，我们对静脉和血管内再灌注策略、AIS神经介入的最新进展、各种治疗模式的局限性进行了全面概述，并对影像引导下的再灌注治疗提供见解。还提出了AIS影像引导下再灌注治疗工作流程的路线图。全身溶栓和血管内治疗均已纳入卒中治疗的护理标准。对基于先进影像的方法进行进一步研究以选择合适的患者，可能会扩大患者选择的时间窗，并将极大地有助于早期溶栓策略、提高再通率和改善临床结局。
