Bershad Eric M, Suarez Jose I
Department of Neurology, Neurocritical Care and Vascular Neurology, Baylor College of Medicine, Houston, TX, USA.
Ann Indian Acad Neurol. 2008 Jan;11(Suppl 1):S30-S38.
Thrombolytic therapy has revolutionized acute ischemic stroke (AIS) treatment; however it is clear that intravenous (IV) thrombolytic therapy has certain limitations, including a short-time window for use, poor specificity for the site of arterial occlusion, and suboptimal recanalization rates. Some of these problems may be circumvented by using intra-arterial (IA) thrombolysis. In this article, we will discuss the various thrombolytic agents being used in AIS, their mechanisms of actions and doses, and the rationale for use of IA therapy as opposed to IV thrombolysis, and review the clinical trials using IA thrombolysis. We will also discuss other approaches to IA thrombolysis, including mechanical and other endovascular techniques.
溶栓治疗彻底改变了急性缺血性卒中（AIS）的治疗方式；然而，静脉溶栓治疗存在一定局限性，包括使用时间窗短、对动脉闭塞部位的特异性差以及再通率不理想等。通过动脉内（IA）溶栓或许可以规避其中一些问题。在本文中，我们将讨论目前用于AIS的各种溶栓药物、它们的作用机制和剂量，以及使用IA治疗而非静脉溶栓的理论依据，并回顾使用IA溶栓的临床试验。我们还将讨论IA溶栓的其他方法，包括机械和其他血管内技术。
