Revascularization therapies for acute stroke patients aim to rescue the ischemic penumbra by restoring the patency of the occluded artery ("recanalization") and the downstream capillary blood flow ("reperfusion"). This article reviews the definition of recanalization and reperfusion used in stroke clinical trials and their limitations and proposes a study design to determine the relative importance of recanalization, reperfusion, and collateral flow in evaluating the efficacy of revascularization therapies for acute ischemic stroke.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1161/STROKEAHA.108.526814 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Role and Prognostic Implications of Venous Outflow Assessment in Acute Ischemic Stroke.
J Neuroimaging
January 2025
Department of Radiology, Division of Neuroradiology, Johns Hopkins Medical Center, Baltimore, Maryland, USA.
Introduction: The venous outflow profile (VOP) is a crucial yet often overlooked aspect affecting stroke outcomes. It plays a major role in the physiopathology of acute cerebral ischemia, as it accounts for both the upstream arterial collaterals and cerebral microperfusion. This enables it to circumvent the limitations of various arterial collateral evaluation systems, which often fail to consider impaired autoregulation and its impact on cerebral blood flow at the microcirculatory levels.
View Article and Find Full Text PDFFirst pass effect in patients with large core infarcts undergoing mechanical thrombectomy: subgroup analysis of the prospective international ASSIST registry.
J Neurointerv Surg
January 2025
Semmes-Murphey Neurologic and Spine Institute, Memphis, Tennessee, USA.
Background: Studies have described a first pass effect (FPE) where patients with successful recanalization after one pass experience better outcomes. Few studies have evaluated this in patients with large core infarctions.
Objective: To determine whether patients with large core infarcts undergoing mechanical thrombectomy in which first pass reperfusion is achieved experience improved outcomes compared with those who undergo more than one pass.
False Lumen Stenting to the Acute Occlusive Carotid Artery Dissection Combined With Intracranial Acute Embolic Stroke: A Case Report and Literature Review.
Cureus
December 2024
Department of Neurosurgery, Hirosaki University Graduate School of Medicine, Hirosaki, JPN.
Tandem occlusion due to acute cervical carotid artery dissection should be promptly treated with thrombectomy for reperfusion. If the cervical lesion has reached severe stenosis or complete occlusion, balloon angioplasty and, in certain cases, carotid artery stenting should be performed before thrombectomy for the intracranial lesion. Angioplasty or stent placement is performed in the true lumen, but securing the placement is challenging when the true lumen cannot be determined.
View Article and Find Full Text PDFSafety of Adjunctive Intraarterial Tenecteplase Following Mechanical Thrombectomy: The ALLY Pilot Trial.
Stroke
January 2025
Department of Neurology, University of Toledo, OH (S.F.Z., A.C.C., R.E.B., H.S.A., K.G., R.R., M.A.J.).
Background: Recent studies suggest that the use of adjunctive intraarterial alteplase after mechanical thrombectomy (MT) may improve outcomes; however, there are limited data on the use of intraarterial tenecteplase, a newer-generation lytic, in this acute ischemic stroke patient population. Here, we evaluate the use of intraarterial tenecteplase in the ALLY pilot study (Adjunctive Intraarterial Tenecteplase Following Mechanical Thrombectomy).
Methods: ALLY was a prospective, single-center, nonrandomized pilot study assessing the feasibility and safety of intraarterial tenecteplase up to 4.
Is Reperfusion Injury a Largely Intra-Ischemic Injury?
Stroke
December 2024
Department of Neurology, Institut de Psychiatrie et Neurosciences de Paris, INSERM U1266, GHU Paris Psychiatrie et Neurosciences, Université Paris Cité, France.
Reperfusion injury (RI) refers to an array of detrimental cellular and biochemical processes that are widely believed to be triggered by reperfusion following focal cerebral ischemia and to contribute to infarct extension and poor outcome despite complete recanalization. Accordingly, it is widely recommended that therapies targeting RI be administered after recanalization. The present topical review demonstrates, however, that the vast majority of, and possibly all, processes considered part of RI are not actually provoked by reperfusion but develop during the ischemic phase.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!