Division of Neurocritical Care, Departments of Neurology, Neurosurgery, and Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland.
Neuroscience Intensive Care Unit, Department of Medicine, Virginia Commonwealth University, Inova Fairfax Medical Campus, Falls Church, Virginia.
Semin Neurol. 2021 Aug;41(4):411-421. doi: 10.1055/s-0041-1726328. Epub 2021 Apr 13.
The use of left ventricular assist devices (LVADs) has been increasing in the last decade, along with the number of patients with advanced heart failure refractory to medical therapy. Ischemic stroke and intracranial hemorrhage remain the leading causes of morbidity and mortality in LVAD patients. Despite the common occurrence and the significant outcome impact, underlying mechanisms and management strategies of stroke in LVAD patients are controversial. In this article, we review our current knowledge on pathophysiology and risk factors of LVAD-associated stroke, outline the diagnostic approach, and discuss treatment strategies.
在过去的十年中，随着对药物治疗无效的晚期心力衰竭患者数量的增加，左心室辅助装置（LVAD）的使用也在增加。缺血性卒中和颅内出血仍然是 LVAD 患者发病率和死亡率的主要原因。尽管卒中在 LVAD 患者中很常见，且对结果有重大影响，但卒中的发病机制和治疗策略仍存在争议。本文综述了我们目前对 LVAD 相关卒中的病理生理学和危险因素的认识，概述了诊断方法，并讨论了治疗策略。
