Sharma Richa, Lee Kun
Department of Neurology, Yale School of Medicine, New Haven, CT, USA
Department of Neurology, Temple University Hospital, Philadelphia, PA, USA.
BMJ. 2025 May 7;389:e076161. doi: 10.1136/bmj-2023-076161.
Acute ischemic stroke is a leading global cause of death and disability. Intravenous thrombolysis was the first acute treatment developed for ischemic strokes. First with alteplase and now with tenecteplase, intravenous thrombolysis has remained a cornerstone of acute ischemic stroke management. In large vessel occlusions, endovascular thrombectomy has become the standard of care in acute stroke management for anterior and posterior circulation strokes. The boundaries for these treatments have expanded, which has improved outcomes in patients who were previously ineligible. This review summarizes the latest advances in interventions for acute ischemic stroke, extending beyond existing guidelines and review articles to explore emerging strategies and treatments currently under investigation.
急性缺血性中风是全球死亡和残疾的主要原因。静脉溶栓是针对缺血性中风开发的首个急性治疗方法。首先是阿替普酶,现在是替奈普酶,静脉溶栓一直是急性缺血性中风治疗的基石。在大血管闭塞中,血管内血栓切除术已成为前循环和后循环中风急性治疗的标准。这些治疗的适用范围有所扩大,这改善了以前不符合条件的患者的治疗效果。本综述总结了急性缺血性中风干预措施的最新进展,不仅涵盖现有指南和综述文章,还探讨了目前正在研究的新兴策略和治疗方法。