Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing 100053, China.
Beijing Institute for Brain Disorders, Capital Medical University, Beijing 100069, China.
Biomolecules. 2024 Sep 20;14(9):1181. doi: 10.3390/biom14091181.
Stroke remains the leading cause of death and disability in some countries, predominantly attributed to acute ischemic stroke (AIS). While intravenous thrombolysis and endovascular thrombectomy are widely acknowledged as effective treatments for AIS, boasting a high recanalization rate, there is a significant discrepancy between the success of revascularization and the mediocre clinical outcomes observed among patients with AIS. It is now increasingly understood that the implementation of effective cerebral protection strategies, serving as adjunctive treatments to reperfusion, can potentially improve the outcomes of AIS patients following recanalization therapy. Herein, we reviewed several promising cerebral protective methods that have the potential to slow down infarct growth and protect ischemic penumbra. We dissect the underlying reasons for the mismatch between high recanalization rates and moderate prognosis and introduce a novel concept of "multi-target and multi-phase adjunctive cerebral protection" to guide our search for neuroprotective agents that can be administered alongside recanalization therapy.
中风仍然是一些国家的主要死亡和残疾原因，主要归因于急性缺血性中风（AIS）。虽然静脉溶栓和血管内血栓切除术被广泛认为是 AIS 的有效治疗方法，具有很高的再通率，但血管再通的成功率与 AIS 患者观察到的中等临床结果之间存在显著差异。现在越来越多的人认识到，实施有效的脑保护策略，作为再灌注的辅助治疗，可能会改善 AIS 患者在再通治疗后的结局。在此，我们回顾了几种有希望的脑保护方法，这些方法有可能减缓梗死的发展并保护缺血半影区。我们剖析了高再通率与中等预后之间不匹配的原因，并引入了“多靶点、多相辅助性脑保护”的新概念，以指导我们寻找可与再通治疗联合应用的神经保护剂。
