Imaging selection for reperfusion therapy in acute ischemic stroke beyond the conventional time window
| Autor: | Anke Wouters, Lauranne Scheldeman, Robin Lemmens |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Neurology medicine.medical_treatment Brain Ischemia law.invention Reperfusion therapy Randomized controlled trial law Time windows medicine Humans Thrombolytic Therapy Intensive care medicine Selection (genetic algorithm) Ischemic Stroke Thrombectomy Neuroradiology medicine.diagnostic_test business.industry Magnetic resonance imaging Thrombolysis Stroke Treatment Outcome Reperfusion Neurology (clinical) Tomography X-Ray Computed business |
| Zdroj: | Journal of Neurology. 269:1715-1723 |
| ISSN: | 1432-1459 0340-5354 |
| DOI: | 10.1007/s00415-021-10872-4 |
| Popis: | Originally, the efficacy of acute ischemic stroke treatment with thrombolysis or thrombectomy was only proven in narrow time windows of, respectively, 4.5 and 6 h after onset. Introducing imaging-based selection beyond non-contrast enhanced computed tomography has expanded the treatment window, focusing on presumed tissue status rather than solely on time after stroke onset. Different mismatch concepts have been adopted in clinical practice to select patients in the extended and unknown time window based on findings from randomized controlled trials. Since various concepts exist that can identify patients likely to benefit from reperfusion strategies, clinicians may wonder which imaging modality may be preferred in the emergency setting. In this review, we will discuss the different mismatch concepts and their practical implementation for patient selection for thrombolysis or thrombectomy, beyond the conventional time window. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full text from SpringerLink