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학술연구/단체지원/교육 등 연구자 활동을 지속하도록 DBpia가 지원하고 있어요.
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연구자들이 자신의 연구와 전문성을 널리 알리고, 새로운 협력의 기회를 만들 수 있는 네트워킹 공간이에요.
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초록· 키워드
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Endovascular therapy (EVT) is an effective treatment for ischemic stroke due to large vessel occlusion (LVO). Unlike intravenous thrombolysis, EVT enables visualization of the restoration of blood flow, also known as successful reperfusion in real time. However, until successful reperfusion is achieved, the survival of the ischemic brain is mainly dependent on blood flow from the leptomeningeal collaterals (LMC). It plays a critical role in maintaining tissue perfusion after LVO via pre-existing channels between the arborizing pial small arteries or arterioles overlying the cerebral hemispheres. In the ischemic territory where the physiologic cerebral autoregulation is impaired and the pial arteries are maximally dilated within their capacity, the direction and amount of LMC perfusion rely on the systemic perfusion, which can be estimated by measuring blood pressure (BP). After the EVT procedure, treatment focuses on mitigating the risk of hemorrhagic transformation, potentially via BP reduction. Thus, BP management may be a key component of acute care for patients with LVO stroke. However, the guidelines on BP management during and after EVT are limited, mostly due to the scarcity of high-level evidence on this issue. In this review, we aim to summarize the anatomical and physiological characteristics of LMC to maintain cerebral perfusion after acute LVO, along with a landscape summary of the literature on BP management in endovascular treatment. The objective of this review is to describe the mechanistic association between systemic BP and collateral perfusion after LVO and thus provide clinical and research perspectives on this topic.
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등록된 정보가 없습니다.
참고문헌 (106)
참고문헌 신청
Goyal M / 2016 / Endovascular thrombectomy after large-vessel ischaemic stroke : a meta-analysis of individual patient data from five randomised trials / Lancet 387:1723~1731
Yu I / 2019 / Admission diffusion-weighted imaging lesion volume in patients with large vessel occlusion stroke and Alberta Stroke Program Early CT Score of ≥6 points : serial computed tomography-magnetic resonance imaging collateral measurements / Stroke 50:3115~3120
Albers GW / 2018 / Late window paradox / Stroke 49:768~771
Winship IR / 2015 / Cerebral collaterals and collateral therapeutics for acute ischemic stroke / Microcirculation 22:228~236
Brozici M / 2003 / Anatomy and functionality of leptomeningeal anastomoses : a review / Stroke 34:2750~2762
Yu I / 2019 / Admission diffusion-weighted imaging lesion volume in patients with large vessel occlusion stroke and Alberta Stroke Program Early CT Score of ≥6 points : serial computed tomography-magnetic resonance imaging collateral measurements / Stroke 50:3115~3120
Albers GW / 2018 / Late window paradox / Stroke 49:768~771
Winship IR / 2015 / Cerebral collaterals and collateral therapeutics for acute ischemic stroke / Microcirculation 22:228~236
Brozici M / 2003 / Anatomy and functionality of leptomeningeal anastomoses : a review / Stroke 34:2750~2762
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