The advanced imaging-guided approach to acute ischemic stroke in the extended reperfusion time window
نویسندگان
چکیده
Evaluation and treatment of acute ischemic stroke has undergone significant advancement since the 1990s, when systemic reperfusion with intravenous alteplase became first approved method for achieving reperfusion. Until recently, 4.5 h after onset appeared to be maximum time window in which positive results from thrombolysis can achieved. However, advent advanced imaging modalities, including multimodal magnetic resonance computed tomography perfusion allowed clinicians refine evaluation these patients by delineating areas infarcted tissue, potentially salvageable tissue given timely reperfusion, benign oligemia. Early work extending beyond this historical limit culminated four trials that demonstrate benefit mechanical or therapy an extended up 24 h, using criteria patient selection. The implications success suggest use modalities disposition decisions selection greater numbers but add complexity individual evaluation. Despite this, many questions remain unanswered, best choice agent, whether we extend further optimal combination thrombectomy bridging late without large vessel occlusion.
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ژورنال
عنوان ژورنال: Vessel plus
سال: 2021
ISSN: ['2574-1209']
DOI: https://doi.org/10.20517/2574-1209.2021.44