Suppr超能文献

急性缺血性卒中患者的延迟血管重建

Delayed revascularization in acute ischemic stroke patients.

作者信息

Eastin T Marc, Dye Justin A, Pillai Promod, Lopez-Gonzalez Miguel A, Huang Lei, Zhang John H, Boling Warren W

机构信息

Department of Neurological Surgery, Loma Linda University Medical Center, Loma Linda, CA, United States.

Department of Pharmacology and Physiology, Loma Linda University, Loma Linda, CA, United States.

出版信息

Front Pharmacol. 2023 Feb 8;14:1124263. doi: 10.3389/fphar.2023.1124263. eCollection 2023.

Abstract

Stroke shares a significant burden of global mortality and disability. A significant decline in the quality of life is attributed to the so-called post-stroke cognitive impairment including mild to severe cognitive alterations, dementia, and functional disability. Currently, only two clinical interventions including pharmacological and mechanical thrombolysis are advised for successful revascularization of the occluded vessel. However, their therapeutic effect is limited to the acute phase of stroke onset only. This often results in the exclusion of a significant number of patients who are unable to reach within the therapeutic window. Advances in neuroimaging technologies have allowed better assessment of salvageable penumbra and occluded vessel status. Improvement in diagnostic tools and the advent of intravascular interventional devices such as stent retrievers have expanded the potential revascularization window. Clinical studies have demonstrated positive outcomes of delayed revascularization beyond the recommended therapeutic window. This review will discuss the current understanding of ischemic stroke, the latest revascularization doctrine, and evidence from clinical studies regarding effective delayed revascularization in ischemic stroke.

摘要

中风是全球死亡和残疾的重大负担。生活质量的显著下降归因于所谓的中风后认知障碍,包括轻度至重度认知改变、痴呆和功能残疾。目前,对于闭塞血管的成功再通,仅建议两种临床干预措施,即药物溶栓和机械溶栓。然而,它们的治疗效果仅局限于中风发作的急性期。这常常导致大量无法在治疗窗内就诊的患者被排除在外。神经成像技术的进步使得对可挽救的半暗带和闭塞血管状态有了更好的评估。诊断工具的改进以及血管内介入装置如取栓支架的出现扩大了潜在的再通窗。临床研究已经证明了在推荐治疗窗之外进行延迟再通的积极结果。本综述将讨论对缺血性中风的当前认识、最新的再通学说以及关于缺血性中风有效延迟再通的临床研究证据。

相似文献

1
Delayed revascularization in acute ischemic stroke patients.
Front Pharmacol. 2023 Feb 8;14:1124263. doi: 10.3389/fphar.2023.1124263. eCollection 2023.
2
Trial design and reporting standards for intra-arterial cerebral thrombolysis for acute ischemic stroke.
Stroke. 2003 Aug;34(8):e109-37. doi: 10.1161/01.STR.0000082721.62796.09. Epub 2003 Jul 17.
3
Extension of therapeutic window in ischemic stroke by selective mismatch imaging.
Int J Stroke. 2019 Jun;14(4):351-358. doi: 10.1177/1747493019840936. Epub 2019 Apr 1.
4
Endovascular Treatment of Thrombosis and Embolism.
Adv Exp Med Biol. 2017;906:195-213. doi: 10.1007/5584_2016_116.
5
Endovascular Thrombectomy for Acute Ischemic Stroke.
Curr Cardiol Rep. 2019 Aug 30;21(10):112. doi: 10.1007/s11886-019-1217-6.
7
Predictors of functional dependence despite successful revascularization in large-vessel occlusion strokes.
Stroke. 2014 Jul;45(7):1977-84. doi: 10.1161/STROKEAHA.114.005603. Epub 2014 May 29.
8
Thrombolysis in acute ischemic stroke: Experience from a tertiary care centre in India.
J Neurosci Rural Pract. 2014 Jan;5(1):25-30. doi: 10.4103/0976-3147.127867.
9
Endovascular Treatment of Acute Ischemic Stroke.
Continuum (Minneap Minn). 2020 Apr;26(2):310-331. doi: 10.1212/CON.0000000000000852.

引用本文的文献

2
Therapeutic Potential of Intravenous miR-21 Mimic after Stroke Following STAIR Criteria.
Transl Stroke Res. 2025 Apr;16(2):403-409. doi: 10.1007/s12975-023-01223-8. Epub 2023 Dec 22.

本文引用的文献

1
Macrophage Infiltration Reduces Neurodegeneration and Improves Stroke Recovery after Delayed Recanalization in Rats.
Oxid Med Cell Longev. 2022 Aug 17;2022:6422202. doi: 10.1155/2022/6422202. eCollection 2022.
3
The core/penumbra model: implications for acute stroke treatment and patient selection in 2021.
Eur J Neurol. 2021 Aug;28(8):2794-2803. doi: 10.1111/ene.14916. Epub 2021 Jun 18.
5
Management and prognosis of acute extracranial internal carotid artery occlusion.
Ann Transl Med. 2020 Oct;8(19):1268. doi: 10.21037/atm-20-3169.
7
Crosstalk between Inflammation and the BBB in Stroke.
Curr Neuropharmacol. 2020;18(12):1227-1236. doi: 10.2174/1570159X18666200620230321.
8
Delayed recanalization after MCAO ameliorates ischemic stroke by inhibiting apoptosis via HGF/c-Met/STAT3/Bcl-2 pathway in rats.
Exp Neurol. 2020 Aug;330:113359. doi: 10.1016/j.expneurol.2020.113359. Epub 2020 May 16.
9
"Incidence and Clinico-Radiological Correlations of Early Arterial Reocclusion After Successful Thrombectomy in Acute Ischemic Stroke".
Transl Stroke Res. 2020 Dec;11(6):1314-1321. doi: 10.1007/s12975-020-00816-x. Epub 2020 Apr 20.
10
Management of acute ischemic stroke.
BMJ. 2020 Feb 13;368:l6983. doi: 10.1136/bmj.l6983.

文献AI研究员

20分钟写一篇综述,助力文献阅读效率提升50倍。

立即体验

用中文搜PubMed

大模型驱动的PubMed中文搜索引擎

马上搜索

文档翻译

学术文献翻译模型,支持多种主流文档格式。

立即体验