Cirillo Luigi, Abdalkader Mohamad, Klein Piers, Yedavalli Vivek S, Siegler James E, Kang Matthew, Shu Liqi, Al Mufti Fawaz, Yaghi Shadi, Ranta Anna, Nguyen Thanh N
Neuroradiology Unit, IRCCS Institute of Neurological Sciences of Bologna, Bologna, Italy.
Department of Biomedical and Neuromotor Sciences - DIBINEM, University of Bologna, Bologna, Italy.
Curr Neurol Neurosci Rep. 2025 May 3;25(1):33. doi: 10.1007/s11910-025-01421-x.
This review aims to evaluate recent advances in large core stroke management with a focus on diagnostic imaging protocols to select patients for endovascular therapy.
Recent randomized controlled trials have shown that thrombectomy can lead to favorable outcomes in patients with large infarcts, contradicting previous assumptions that thrombectomy was not indicated in such patients due to higher risks and very low benefits. Although mechanical thrombectomy remains the gold standard of medical treatment for large vessel occlusions with demonstrated salvageable brain tissue, analysis of the results of recent randomized trials in patients with large ischemic stroke should help us expand patient selection, optimize timing, and explore different management modalities to improve the outcomes of therapy in these patients.
本综述旨在评估大面积核心梗死性卒中管理的最新进展，重点关注用于选择血管内治疗患者的诊断成像方案。
近期的随机对照试验表明，血栓切除术可使大面积梗死患者获得良好预后，这与之前的假设相矛盾，即由于风险较高且获益极低，此类患者不适合进行血栓切除术。尽管机械取栓仍然是具有可挽救脑组织的大血管闭塞性疾病的药物治疗金标准，但对近期大面积缺血性卒中患者随机试验结果的分析应有助于我们扩大患者选择范围、优化治疗时机，并探索不同的管理模式，以改善这些患者的治疗效果。
