Fraser Justin F, Pahwa Shivani, Maniskas Michael, Michas Christopher, Martinez Mesha, Pennypacker Keith R, Dornbos David
Department of Neurological Surgery, University of Kentucky, Lexington, Kentucky, USA
Department of Neurology, University of Kentucky, Lexington, Kentucky, USA.
J Neurointerv Surg. 2024 Mar 14;16(4):425-428. doi: 10.1136/jnis-2022-019293.
The last 10 years have seen a major shift in management of large vessel ischemic stroke with changes towards ever-expanding use of reperfusion therapies (intravenous thrombolysis and mechanical thrombectomy). These strategies 'open the door' to acute therapeutics for ischemic tissue, and we should investigate novel therapeutic approaches to enhance survival of recently reperfused brain. Key insights into new approaches have been provided through translational research models and preclinical paradigms, and through detailed research on ischemic mechanisms. Additional recent clinical trials offer exciting salvos into this new strategy of pairing reperfusion with neuroprotective therapy. This pairing strategy can be employed using drugs that have shown neuroprotective efficacy; neurointerventionalists can administer these during or immediately after reperfusion therapy. This represents a crucial moment when we emphasize reperfusion, and have the technological capability along with the clinical trial experience to lead the way in multiprong approaches to stroke treatment.
在过去十年中，大血管缺血性卒中的管理发生了重大转变，再灌注治疗（静脉溶栓和机械取栓）的使用不断扩大。这些策略为缺血组织的急性治疗“打开了大门”，我们应该研究新的治疗方法，以提高近期再灌注脑的存活率。通过转化研究模型和临床前范例，以及对缺血机制的详细研究，为新方法提供了关键见解。最近的其他临床试验为这种将再灌注与神经保护治疗相结合的新策略提供了令人兴奋的成果。这种配对策略可以使用已显示出神经保护功效的药物来实施；神经介入医生可以在再灌注治疗期间或之后立即给予这些药物。这是一个关键时刻，我们强调再灌注，并且拥有技术能力和临床试验经验，能够在多管齐下的卒中治疗方法中引领道路。
