CASE OF SUCCESSFUL RECANALIZATION IN ISCHEMIC STROKE PATIENT WITH COMBINED APPLICATION OF INTRAVENOUS THROMBOLYTIC THERAPY AND THROMBEXTRACTION


如何引用文章

全文:

开放存取 开放存取
受限制的访问 ##reader.subscriptionAccessGranted##
受限制的访问 订阅或者付费存取

详细

Background. Ischemic stroke occupies a leading position among the topical problems of modern medicine due to the high incidence of the disease, as well as a large percentage of disability and mortality. In recent years, intravenous thrombolytic therapy has become a part of the routine methods of treating cerebral stroke with an annual increase in the absolute number of procedures performed in the Russian Federation. At the present time, mechanical thromboextraction is an actively developing field of treatment of ischemic stroke. Description of the clinical case. This clinical observation describes a patient with ischemic stroke in the right middle cerebral artery territory admitted to the hospital at an early stage from the onset of the disease, who underwent the procedure of combined reperfusion therapy with a good clinical and angiographic effect, as well as an evaluation of the long-term results. Conclusion. The presented clinical observation demonstrates the high efficacy and safety of the combination of intravenous thrombolytic therapy and mechanical thromboextraction.

全文:

受限制的访问

作者简介

L. Laypanova

City Clinical Hospital № 31, Moscow; Pirogov Russian National Research Medical University

Email: Mizheva54@mail.ru
Neurologist of the intensive care unit for patients with acute cerebrovascular accident, CCH № 31, Postgraduate Student at the Department of Neurology, Neurosurgery and Medical Genetics of the Therapeutic Faculty of the Pirogov RNRMU

A. Zlatovratsky

City Clinical Hospital № 31, Moscow

A. Lukyanov

City Clinical Hospital № 31, Moscow; Pirogov Russian National Research Medical University

L. Mikhaleva

City Clinical Hospital № 31, Moscow; Research Institute of human morphology

N. Shamalov

Pirogov Russian National Research Medical University

参考

  1. Krishnamurthi R.V., Feigin V.L., Forouzanfar M.H., et al.; Global Burden of Diseases, Injuries, Risk Factors Study 2010 (GBD 2010); GBD Stroke Experts Group. Global and regional burden of first-ever ischaemic and haemorrhagic stroke during 1990-2010: findings from the Global Burden of Disease Study 2010. Lancet Glob. Health. 2013;1(5):e259-81.
  2. Стаховская Л.В., Клочихина О.А. Характеристика основных типов инсульта в России (по данным территориально-популяционного регистра 2009-2013 гг. Consilium medicum. 2015;9:8-11.
  3. Шамалов Н.А., Стаховская Л.В., Тихонова М.А., и др. Развитие реперфузионной терапии при ишемическом инсульте в Российской Федерации: достижения и перспективы. Фарматека. 2017;9:66-70.
  4. Савелло А.В., Вознюк И.А., Свистов Д.В. Внутрисосудистое лечение ишемического инсульта в острейшем периоде. 2015. С. 11-24.
  5. Скворцова В.И., Голухо Т.Н., Волынский Ю.Д. и др. Высокая эффективность селективного внутриартериального тромболизиса при лечении ишемического инсульта у больных с окклюзией артерий крупного калибра. Журнал Неврологии и психиатрии им. С.С. Корсакова. 2006;12:32-40.
  6. Lisboa C., Jovanovic B.D., Alberts M.J. Analysis of the Safety and Efficacy of Intra-Arterial Thrombolytic Therapy in Ischemic Stroke. Stroke. 2002;33(12):2866-71.
  7. Шамалов Н.А., Анисимов К.В., Кустова М.А. и др. Тромбо-литическая терапия при ишемическом инсульте: предикторы безопасности и эффективности. Фарматека. 2014;19:30-5.
  8. Шамалов Н.А., Анисимов К.В., Кустова М.А., Толмачев А.П. Факторы, влияющие на эффективность и безопасность системного тромболизиса у пациентов с ишемическим инсультом. Неврология, нейропсихиатрия, психосоматика. 2014;3:61-8.
  9. Emberson J., Lees K.R., Lyden P., et al; Stroke Thrombolysis Trialists' Collaborative Group. Effect of treatment delay, age, and stroke severity on the effects of intravenous thrombolysis with alteplase for acute ischaemic stroke: a meta-analysis of individual patient data from randomised trials. Lancet. 2014;384(9958):1929-35. doi: 10.1016/S0140-6736(14)60584-5.
  10. Riedel C.H., Zimmermann P., Jensen-Kondering U., et al. The importance of size: successful recanalization by intravenous thrombolysis in acute anterior stroke depends on thrombus length. Stroke. 2011;42(6):1775-77. Doi: 10.1161/ STROKEAHA.110.609693.
  11. Turk A.S., Spiotta A., Frei D., et al. Initial clinical experience with the ADAPT technique: a direct aspiration first pass technique for stroke thrombectomy. J. Neurointerv. Surg. 2014;6(3):231-37. Doi: 10.1136/ neurintsurg-2013-010713.
  12. Jovin T.G., Chamorro A., Cobo E., et al.; REVASCAT Trial Investigators. Thrombectomy within 8 Hours after Symptom Onset in Ischemic Stroke. N. Engl. J. Med. 2015;372(24):2296-306. Doi: 10.1056/ NEJMoa1503780.
  13. Saver J.L., Goyal M., Bonafe A., et al.; SWIFT PRIME Investigators. Stent-Retriever Thrombectomy after Intravenous t-PA vs. t-PA Alone in Stroke. N. Engl. J. Med. 2015;372(24):2285-95. Doi: 10.1056/ NEJMoa1415061.
  14. Goyal M., Demchuk A.M., Menon B.K., et al.; ESCAPE Trial Investigators. Randomized Assessment of Rapid Endovascular Treatment of Ischemic Stroke. N. Engl. J. Med. 2015;372(11):1019-30. Doi: 10.1056/ NEJMoa1414905.
  15. Campbell B.C., Mitchell P.J., Kleinig T.J., et al.; EXTEND-IA Investigators. Endovascular Therapy for Ischemic Stroke with Perfusion-Imaging Selection. N. Engl. J. Med. 2015;372(11):1009-18. Doi: 10.1056/ NEJMoa1414792.
  16. Berkhemer O.A., Fransen P.S., Beumer D., et al. MR CLEAN Investigators. A Randomized Trial of Intraarterial Treatment for Acute Ischemic Stroke. N. Engl. J. Med. 2015;372(1):11-20.
  17. Lapergue B., Blanc R., Gory B., et al.; ASTER Trial Investigators. Effect of Endovascular Contact Aspiration vs Stent Retriever on Revascularization in Patients With Acute Ischemic Stroke and Large Vessel Occlusion: The ASTER Randomized Clinical Trial. JAMA. 2017;318:443-52. doi: 10.1001/jama.2017.9644.
  18. Jovin T.G., Saver J.L., Ribo M., et al. Diffusion-weighted imaging or computerized tomography perfusion assessment with clinical mismatch in the triage of wake up and late presenting strokes undergoing neurointervention with Trevo (DAWN) trial methods. Int. J. Stroke. 2017;12(6):641-52. doi: 10.1177/1747493017710341.
  19. Furie K.L., Jayaraman M.V. 2018 Guidelines for the Early Management of Patients With Acute Ischemic Stroke. Stroke. 2018;49(3):509-10. Doi: 10.1161/ STROKEAHA.118.020176.
  20. Yarbrough C.K., Ong C.J., Beyer A.B., et al. Endovascular Thrombectomy for Anterior Circulation Stroke: Systematic Review and Meta-Analysis. Stroke. 2015;46:3177-83. doi: 10.1161/STROKEAHA.115.009847.

补充文件

附件文件
动作
1. JATS XML

版权所有 © Bionika Media, 2018
##common.cookie##