뇌졸중 최신지견 2009: 혈전용해술
Stroke Update 2009: Thrombolysis
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초록
Many important discovery and new evidences of stroke research were reported in 2009. This review will discuss main advances in the thrombolytic therapy. Concept of diffusion-perfusion mismatch for the candidate patient selection is evolving to the concept of Magnetic Resonance Angiography (MRA)-diffusion mismatch. In the field of new thrombolytic agent, TNK-tissue plasminogen activator (TNK-tPA) and microplasmin were tested in the stroke patients. Mechanical Embolus Removal in Cerebral Ischemia (MERCI) and Penumbra are two mainstream of thrombolytic device development, and each reported their success rate. To prevent early re-occlusion, possibility of combination therapy with antiplatelet is raised. Challenging situations for the thrombolysis such as transient ischemic attack, hyperdense middle cerebral artery (MCA) sign, and carotid artery dissection are also discussed.
Abstract
Many important discovery and new evidences of stroke research were reported in 2009. This review will discuss main advances in the thrombolytic therapy. Concept of diffusion-perfusion mismatch for the candidate patient selection is evolving to the concept of Magnetic Resonance Angiography (MRA)-diffusion mismatch. In the field of new thrombolytic agent, TNK-tissue plasminogen activator (TNK-tPA) and microplasmin were tested in the stroke patients. Mechanical Embolus Removal in Cerebral Ischemia (MERCI) and Penumbra are two mainstream of thrombolytic device development, and each reported their success rate. To prevent early re-occlusion, possibility of combination therapy with antiplatelet is raised. Challenging situations for the thrombolysis such as transient ischemic attack, hyperdense middle cerebral artery (MCA) sign, and carotid artery dissection are also discussed.
참고문헌 (17)
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