Division of Neurology, The Ottawa Hospital and Ottawa Hospital Research Institute, University of Ottawa, Canada (V.Y.).
Department of Neurology, Melbourne Brain Centre at the Royal Melbourne Hospital, University of Melbourne, Australia (V.Y., B.C.V.C.).
Stroke. 2024 Oct;55(10):2536-2546. doi: 10.1161/STROKEAHA.124.045755. Epub 2024 Aug 6.
Thrombolytic therapies for acute ischemic stroke are widely available but only result in recanalization early enough, to be therapeutically useful, in 10% to 30% of cases. This large gap in treatment effectiveness could be filled by novel therapies that can increase the effectiveness of thrombus clearance without significantly increasing the risk of harm. This focused update will describe the current state of emerging adjuvant treatments for acute ischemic stroke reperfusion. We focus on new treatments that are designed to (1) target different components that make up a stroke thrombus, (2) enhance endogenous fibrinolytic systems, (3) reduce stagnant blood flow, and (4) improve recanalization of distal thrombi and postendovascular thrombectomy.
急性缺血性脑卒中的溶栓治疗应用广泛，但只有 10%~30%的患者能在足够早的时间实现再通，从而获得治疗效果。新型治疗方法可能会增加血栓清除的效果，而不会显著增加伤害风险，有望填补这一治疗效果的巨大差距。本次重点更新将描述急性缺血性脑卒中再灌注治疗中新兴辅助治疗的现状。我们重点关注旨在（1）针对构成血栓的不同成分，（2）增强内源性纤维蛋白溶解系统，（3）减少血流停滞，以及（4）改善远端血栓再通和血管内血栓切除术后的再通的新治疗方法。
