医学
病理生理学
冲程(发动机)
缺血性中风
无回流现象
心脏病学
缺血
重症监护医学
内科学
心肌梗塞
机械工程
工程类
经皮冠状动脉介入治疗
作者
Gang Deng,Yun‐Hui Chu,Jun Xiao,Ke Shang,Luo‐Qi Zhou,Chuan Qin,Dai‐Shi Tian
出处
期刊:Aging and Disease
[Aging and Disease]
日期:2023-01-01
卷期号:14 (6): 2096-2096
被引量:11
标识
DOI:10.14336/ad.2023.0321-1
摘要
Endovascular therapy is the first-line treatment for acute ischemic stroke. However, studies have shown that, even with the timely opening of occluded blood vessels, nearly half of all patients treated with endovascular therapy for acute ischemic stroke still have poor functional recovery, a phenomenon called “futile recanalization.”. The pathophysiology of futile recanalization is complex and may include tissue no-reflow (microcirculation reperfusion failure despite recanalization of the occluded large artery), early arterial reocclusion (reocclusion of the recanalized artery 24-48 hours post endovascular therapy), poor collateral circulation, hemorrhagic transformation (cerebral bleeding following primary ischemic stroke), impaired cerebrovascular autoregulation, and large hypoperfusion volume. Therapeutic strategies targeting these mechanisms have been attempted in preclinical research; however, translation to the bedside remains to be explored. This review summarizes the risk factors, pathophysiological mechanisms, and targeted therapy strategies of futile recanalization, focusing on the mechanisms and targeted therapy strategies of no-reflow to deepen the understanding of this phenomenon and provide new translational research ideas and potential intervention targets for improving the efficacy of endovascular therapy for acute ischemic stroke.
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