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心脑缺血中的溶栓和经皮冠状动脉介入治疗:联合策略的实例

Thrombolysis and percutaneous coronary intervention in cardio-cerebral ischemia: A case for a combined strategy.

作者信息

Mylavarapu Maneeth, Kodali Lakshmi Sai Meghana

机构信息

Department of Public Health, Adelphi University, Garden City, NY 11530, United States.

Department of Public Health and Health Sciences, University of Michigan, Flint, MI 48502, United States.

出版信息

World J Clin Cases. 2025 Oct 16;13(29):108924. doi: 10.12998/wjcc.v13.i29.108924.

Abstract

Co-occurrence of acute ischemic stroke and acute myocardial infarction, named concomitant cerebrocardiac infarction, is a rare yet critical medical challenge. Optimal management strategies remain undefined, particularly for ST-segment elevation myocardial infarction. This editorial discusses a case report by Zheng and Liu, where a 27-year-old male with simultaneous acute transmural anterior myocardial infarction and acute ischemic stroke was treated with urgent thrombolysis followed by elective percutaneous coronary intervention. We offer a perspective on the rationale behind this combined approach, discussing the delicate balance of addressing acute stroke and myocardial infarction. This commentary highlights the critical need for further research and clinical discussion to develop evidence-based strategies for optimal patient care in these complex, time-sensitive cases, encouraging critical evaluation of current practices.

摘要

急性缺血性中风和急性心肌梗死同时发生,即所谓的伴随性脑心梗死,是一种罕见但严峻的医学挑战。最佳治疗策略仍不明确,尤其是对于ST段抬高型心肌梗死。这篇社论讨论了郑(音译)和刘(音译)的一篇病例报告,该报告讲述了一名27岁男性同时发生急性透壁性前壁心肌梗死和急性缺血性中风,先接受了紧急溶栓治疗,随后进行了择期经皮冠状动脉介入治疗。我们对这种联合治疗方法背后的原理提出了一种观点,讨论了应对急性中风和心肌梗死时的微妙平衡。这篇评论强调了进一步研究和临床讨论的迫切需求,以便为这些复杂且对时间敏感的病例制定基于证据的最佳患者护理策略,鼓励对当前做法进行批判性评估。

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Treatment of Acute Stroke: Current Practices and Future Horizons.急性脑卒中的治疗:现状与未来展望。
Cardiovasc Revasc Med. 2023 Apr;49:56-65. doi: 10.1016/j.carrev.2022.11.012. Epub 2022 Nov 25.

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