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Реперфузионная терапия при ишемическом инсульте в вертебрально-базилярной системе
Реперфузионная терапия при ишемическом инсульте в вертебрально-базилярной системе
Толмачев А.П., Анисимов К.В., Шамалов Н.А. Реперфузионная терапия при ишемическом инсульте в вертебрально-базилярной системе. Consilium Medicum. 2016; 18 (2): 18–21. DOI: 10.26442/2075-1753_2016.2.18-21
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Аннотация
Ишемический инсульт в вертебрально-базилярной системе (ВБС) характеризуется высоким показателем летальности и значительной частотой инвалидизации у выживших пациентов. Проведение реперфузионной терапии у больных с локализацией очага поражения в ВБС в некоторых случаях является безопасным и эффективным за пределами 4,5-часового терапевтического окна. Активно развивающиеся в настоящее время методы эндоваскулярного лечения острого ишемического инсульта предоставляют дополнительные возможности увеличения частоты реканализации и, как следствие, улучшения степени функционального восстановления у этой группы пациентов.
Ключевые слова: ишемический инсульт, реперфузионная терапия, вертебрально-базилярная система.
Key words: ischemic stroke, reperfusion therapy, vertebral-basilar system.
Ключевые слова: ишемический инсульт, реперфузионная терапия, вертебрально-базилярная система.
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Key words: ischemic stroke, reperfusion therapy, vertebral-basilar system.
Полный текст
Список литературы
1. Caplan L. Posterior circulation ischemia: then, now, and tomorrow. The Thomas Willis Lecture-2000. Stroke 2000; 31 (8): 2011–23.
2. Gulli G, Khan S, Markus HS. Vertebrobasilar stenosis predicts high early recurrent stroke risk in posterior circulation stroke and TIA. Stroke 2009; 40 (8): 2732–7.
3. Caplan LR et al. New England Medical Center Posterior Circulation registry. Ann Neurol 2004; 56 (3): 389–98.
4. Gomez CR et al. "Locked-in" syndrome. Stroke 1987; 18 (1): 275.
5. Антонов И.П., Гиткина Л.С. Вертебрально-базилярные инсульты. Минск: Беларусь, 1977. / Antonov I.P., Gitkina L.S. Vertebral'no-baziliarnye insul'ty. Minsk: Belarus', 1977. [in Russian]
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7. Верещагин Н.В. Патология вертебрально-базилярной системы и нарушения мозгового кровообращения. М.: Медицина, 1980. / Vereshchagin N.V. Patologiia vertebral'no-baziliarnoi sistemy i narusheniia mozgovogo krovoobrashcheniia. M.: Meditsina, 1980. [in Russian]
8. Шулешова Н.В., Вишневский А.А. Ствол головного мозга: Клиника и патофизиологические сопоставления. СПб: Гиппократ, 2006. / Shuleshova N.V., Vishnevskii A.A. Stvol golovnogo mozga: Klinika i patofiziologicheskie sopostavleniia. SPb: Gippokrat, 2006. [in Russian]
9. Беленькая Р.М. Инсульт и варианты артерий мозга. М.: Медицина, 1979. / Belen'kaia R.M. Insul't i varianty arterii mozga. M.: Meditsina, 1979. [in Russian]
10. Cao F, Hata R, Zhu P et al. Delayed neuronal cell death in brainstem after transient brainstem ischemia in gerbils. BMC Neurosci 2010; 14 (11): 115-126.
11. Hata R, Matsumoto M, Hatakeyama T et al. Differential vulnerability in the hindbrain neurons and local cerebral blood flow during bilateral vertebral occlusion in gerbils. Neuroscience 1993; 56: 423–39.
12. Millikan CH, Siekert RG, Shick RM. Studies in cerebrovascular disease. The use of anticoagulant drugs in the treatment of insufficiency or thrombosis within the basilar arterial system. Proc Staff Meet Mayo Clin 1955; 30: 116–26.
13. Whisnant JP. Cerebral vascular diseases: Third princeton conference on cerebrovascular diseases. Grune & Stratton 1961: 156–7.
14. Hacke W, Zeumer H, Ferbert A et al. Intra-arterial thrombolytic therapy improves outcome in patients with acute vertebrobasilar occlusive disease. Stroke 1988; 19: 1216–22.
15. Brandt T, von Kummer R, Muller-Kuppers M, Hacke W. Thrombolytic therapy of acute basilar artery occlusion. Variables affecting recanalization and outcome. Stroke 1996; 27: 875–81.
16. Strbian D, Sairanen T, Silvennoinen H et al. Intravenous Thrombolysis of Basilar Artery Occlusion: Thrombus Length Versus Recanalization Success. Stroke 2014; 45 (6): 1733–8.
17. Lindsberg PJ, Mattle HP. Therapy of basilar artery occlusion: a systematic analysis comparing intra-arterial and intravenous thrombolysis. Stroke 2006; 37 (3): 922–8.
18. Broussalis E, Hitzl W, McCoy M et al. Comparison of endovascular treatment versus conservative medical treatment in patients with acute basilar artery occlusion. Vasc Endovascular Surg 2013; 47 (6): 429–37.
19. Schonewille WJ, Wijman CA, Michel P et al. Treatment and outcomes of acute basilar artery occlusion in the basilar artery international cooperation study (basics): A prospective registry study. Lancet Neurol 2009; 8: 724–30.
20. Pfefferkorn T, Mayer TE, Opherk C et al. Staged escalation therapy in acute basilar artery occlusion: Intravenous thrombolysis and on-demand consecutive endovascular mechanical thrombectomy: Preliminary experience in 16 patients. Stroke 2008; 39: 1496–500.
21. Martin-Schild S, Morales MM, Khaja AM et al. Is the drip-and-ship approach to delivering thrombolysis for acute ischemic stroke safe? J Emerg Med 2009.
22. Silverman IE, Beland DK, Chhabra J, McCullough LD. The "Drip-and-ship" Approach: Starting iv t-pa for acute ischemic stroke at outside hospitals prior to transfer to a regional stroke center. Conn Med 2005; 69: 613–20.
23. Pfefferkorn T, Holtmannspotter M, Schmidt C et al. Drip, ship, and retrieve: Cooperative recanalization therapy in acute basilar artery occlusion. Stroke 2010; 5–6: 722–6.
24. Mayer TE, Hamann GF, Brueckmann HJ. Treatment of basilar artery embolism with a mechanical extraction device: Necessity of flow reversal. Stroke 2002; 33: 2232–5.
2. Gulli G, Khan S, Markus HS. Vertebrobasilar stenosis predicts high early recurrent stroke risk in posterior circulation stroke and TIA. Stroke 2009; 40 (8): 2732–7.
3. Caplan LR et al. New England Medical Center Posterior Circulation registry. Ann Neurol 2004; 56 (3): 389–98.
4. Gomez CR et al. "Locked-in" syndrome. Stroke 1987; 18 (1): 275.
5. Antonov I.P., Gitkina L.S. Vertebral'no-baziliarnye insul'ty. Minsk: Belarus', 1977. [in Russian]
6. Bekov D.B., Mikhailov S.S. Atlas arterii i ven golovnogo mozga cheloveka. Moskva: Meditsina, 1979. [in Russian]
7. Vereshchagin N.V. Patologiia vertebral'no-baziliarnoi sistemy i narusheniia mozgovogo krovoobrashcheniia. M.: Meditsina, 1980. [in Russian]
8. Shuleshova N.V., Vishnevskii A.A. Stvol golovnogo mozga: Klinika i patofiziologicheskie sopostavleniia. SPb: Gippokrat, 2006. [in Russian]
9. Belen'kaia R.M. Insul't i varianty arterii mozga. M.: Meditsina, 1979. [in Russian]
10. Cao F, Hata R, Zhu P et al. Delayed neuronal cell death in brainstem after transient brainstem ischemia in gerbils. BMC Neurosci 2010; 14 (11): 115-126.
11. Hata R, Matsumoto M, Hatakeyama T et al. Differential vulnerability in the hindbrain neurons and local cerebral blood flow during bilateral vertebral occlusion in gerbils. Neuroscience 1993; 56: 423–39.
12. Millikan CH, Siekert RG, Shick RM. Studies in cerebrovascular disease. The use of anticoagulant drugs in the treatment of insufficiency or thrombosis within the basilar arterial system. Proc Staff Meet Mayo Clin 1955; 30: 116–26.
13. Whisnant JP. Cerebral vascular diseases: Third princeton conference on cerebrovascular diseases. Grune & Stratton 1961: 156–7.
14. Hacke W, Zeumer H, Ferbert A et al. Intra-arterial thrombolytic therapy improves outcome in patients with acute vertebrobasilar occlusive disease. Stroke 1988; 19: 1216–22.
15. Brandt T, von Kummer R, Muller-Kuppers M, Hacke W. Thrombolytic therapy of acute basilar artery occlusion. Variables affecting recanalization and outcome. Stroke 1996; 27: 875–81.
16. Strbian D, Sairanen T, Silvennoinen H et al. Intravenous Thrombolysis of Basilar Artery Occlusion: Thrombus Length Versus Recanalization Success. Stroke 2014; 45 (6): 1733–8.
17. Lindsberg PJ, Mattle HP. Therapy of basilar artery occlusion: a systematic analysis comparing intra-arterial and intravenous thrombolysis. Stroke 2006; 37 (3): 922–8.
18. Broussalis E, Hitzl W, McCoy M et al. Comparison of endovascular treatment versus conservative medical treatment in patients with acute basilar artery occlusion. Vasc Endovascular Surg 2013; 47 (6): 429–37.
19. Schonewille WJ, Wijman CA, Michel P et al. Treatment and outcomes of acute basilar artery occlusion in the basilar artery international cooperation study (basics): A prospective registry study. Lancet Neurol 2009; 8: 724–30.
20. Pfefferkorn T, Mayer TE, Opherk C et al. Staged escalation therapy in acute basilar artery occlusion: Intravenous thrombolysis and on-demand consecutive endovascular mechanical thrombectomy: Preliminary experience in 16 patients. Stroke 2008; 39: 1496–500.
21. Martin-Schild S, Morales MM, Khaja AM et al. Is the drip-and-ship approach to delivering thrombolysis for acute ischemic stroke safe? J Emerg Med 2009.
22. Silverman IE, Beland DK, Chhabra J, McCullough LD. The "Drip-and-ship" Approach: Starting iv t-pa for acute ischemic stroke at outside hospitals prior to transfer to a regional stroke center. Conn Med 2005; 69: 613–20.
23. Pfefferkorn T, Holtmannspotter M, Schmidt C et al. Drip, ship, and retrieve: Cooperative recanalization therapy in acute basilar artery occlusion. Stroke 2010; 5–6: 722–6.
24. Mayer TE, Hamann GF, Brueckmann HJ. Treatment of basilar artery embolism with a mechanical extraction device: Necessity of flow reversal. Stroke 2002; 33: 2232–5.
2. Gulli G, Khan S, Markus HS. Vertebrobasilar stenosis predicts high early recurrent stroke risk in posterior circulation stroke and TIA. Stroke 2009; 40 (8): 2732–7.
3. Caplan LR et al. New England Medical Center Posterior Circulation registry. Ann Neurol 2004; 56 (3): 389–98.
4. Gomez CR et al. "Locked-in" syndrome. Stroke 1987; 18 (1): 275.
5. Антонов И.П., Гиткина Л.С. Вертебрально-базилярные инсульты. Минск: Беларусь, 1977. / Antonov I.P., Gitkina L.S. Vertebral'no-baziliarnye insul'ty. Minsk: Belarus', 1977. [in Russian]
6. Беков Д.Б., Михайлов С.С. Атлас артерий и вен головного мозга человека. Москва: Медицина, 1979. / Bekov D.B., Mikhailov S.S. Atlas arterii i ven golovnogo mozga cheloveka. Moskva: Meditsina, 1979. [in Russian]
7. Верещагин Н.В. Патология вертебрально-базилярной системы и нарушения мозгового кровообращения. М.: Медицина, 1980. / Vereshchagin N.V. Patologiia vertebral'no-baziliarnoi sistemy i narusheniia mozgovogo krovoobrashcheniia. M.: Meditsina, 1980. [in Russian]
8. Шулешова Н.В., Вишневский А.А. Ствол головного мозга: Клиника и патофизиологические сопоставления. СПб: Гиппократ, 2006. / Shuleshova N.V., Vishnevskii A.A. Stvol golovnogo mozga: Klinika i patofiziologicheskie sopostavleniia. SPb: Gippokrat, 2006. [in Russian]
9. Беленькая Р.М. Инсульт и варианты артерий мозга. М.: Медицина, 1979. / Belen'kaia R.M. Insul't i varianty arterii mozga. M.: Meditsina, 1979. [in Russian]
10. Cao F, Hata R, Zhu P et al. Delayed neuronal cell death in brainstem after transient brainstem ischemia in gerbils. BMC Neurosci 2010; 14 (11): 115-126.
11. Hata R, Matsumoto M, Hatakeyama T et al. Differential vulnerability in the hindbrain neurons and local cerebral blood flow during bilateral vertebral occlusion in gerbils. Neuroscience 1993; 56: 423–39.
12. Millikan CH, Siekert RG, Shick RM. Studies in cerebrovascular disease. The use of anticoagulant drugs in the treatment of insufficiency or thrombosis within the basilar arterial system. Proc Staff Meet Mayo Clin 1955; 30: 116–26.
13. Whisnant JP. Cerebral vascular diseases: Third princeton conference on cerebrovascular diseases. Grune & Stratton 1961: 156–7.
14. Hacke W, Zeumer H, Ferbert A et al. Intra-arterial thrombolytic therapy improves outcome in patients with acute vertebrobasilar occlusive disease. Stroke 1988; 19: 1216–22.
15. Brandt T, von Kummer R, Muller-Kuppers M, Hacke W. Thrombolytic therapy of acute basilar artery occlusion. Variables affecting recanalization and outcome. Stroke 1996; 27: 875–81.
16. Strbian D, Sairanen T, Silvennoinen H et al. Intravenous Thrombolysis of Basilar Artery Occlusion: Thrombus Length Versus Recanalization Success. Stroke 2014; 45 (6): 1733–8.
17. Lindsberg PJ, Mattle HP. Therapy of basilar artery occlusion: a systematic analysis comparing intra-arterial and intravenous thrombolysis. Stroke 2006; 37 (3): 922–8.
18. Broussalis E, Hitzl W, McCoy M et al. Comparison of endovascular treatment versus conservative medical treatment in patients with acute basilar artery occlusion. Vasc Endovascular Surg 2013; 47 (6): 429–37.
19. Schonewille WJ, Wijman CA, Michel P et al. Treatment and outcomes of acute basilar artery occlusion in the basilar artery international cooperation study (basics): A prospective registry study. Lancet Neurol 2009; 8: 724–30.
20. Pfefferkorn T, Mayer TE, Opherk C et al. Staged escalation therapy in acute basilar artery occlusion: Intravenous thrombolysis and on-demand consecutive endovascular mechanical thrombectomy: Preliminary experience in 16 patients. Stroke 2008; 39: 1496–500.
21. Martin-Schild S, Morales MM, Khaja AM et al. Is the drip-and-ship approach to delivering thrombolysis for acute ischemic stroke safe? J Emerg Med 2009.
22. Silverman IE, Beland DK, Chhabra J, McCullough LD. The "Drip-and-ship" Approach: Starting iv t-pa for acute ischemic stroke at outside hospitals prior to transfer to a regional stroke center. Conn Med 2005; 69: 613–20.
23. Pfefferkorn T, Holtmannspotter M, Schmidt C et al. Drip, ship, and retrieve: Cooperative recanalization therapy in acute basilar artery occlusion. Stroke 2010; 5–6: 722–6.
24. Mayer TE, Hamann GF, Brueckmann HJ. Treatment of basilar artery embolism with a mechanical extraction device: Necessity of flow reversal. Stroke 2002; 33: 2232–5.
________________________________________________
2. Gulli G, Khan S, Markus HS. Vertebrobasilar stenosis predicts high early recurrent stroke risk in posterior circulation stroke and TIA. Stroke 2009; 40 (8): 2732–7.
3. Caplan LR et al. New England Medical Center Posterior Circulation registry. Ann Neurol 2004; 56 (3): 389–98.
4. Gomez CR et al. "Locked-in" syndrome. Stroke 1987; 18 (1): 275.
5. Antonov I.P., Gitkina L.S. Vertebral'no-baziliarnye insul'ty. Minsk: Belarus', 1977. [in Russian]
6. Bekov D.B., Mikhailov S.S. Atlas arterii i ven golovnogo mozga cheloveka. Moskva: Meditsina, 1979. [in Russian]
7. Vereshchagin N.V. Patologiia vertebral'no-baziliarnoi sistemy i narusheniia mozgovogo krovoobrashcheniia. M.: Meditsina, 1980. [in Russian]
8. Shuleshova N.V., Vishnevskii A.A. Stvol golovnogo mozga: Klinika i patofiziologicheskie sopostavleniia. SPb: Gippokrat, 2006. [in Russian]
9. Belen'kaia R.M. Insul't i varianty arterii mozga. M.: Meditsina, 1979. [in Russian]
10. Cao F, Hata R, Zhu P et al. Delayed neuronal cell death in brainstem after transient brainstem ischemia in gerbils. BMC Neurosci 2010; 14 (11): 115-126.
11. Hata R, Matsumoto M, Hatakeyama T et al. Differential vulnerability in the hindbrain neurons and local cerebral blood flow during bilateral vertebral occlusion in gerbils. Neuroscience 1993; 56: 423–39.
12. Millikan CH, Siekert RG, Shick RM. Studies in cerebrovascular disease. The use of anticoagulant drugs in the treatment of insufficiency or thrombosis within the basilar arterial system. Proc Staff Meet Mayo Clin 1955; 30: 116–26.
13. Whisnant JP. Cerebral vascular diseases: Third princeton conference on cerebrovascular diseases. Grune & Stratton 1961: 156–7.
14. Hacke W, Zeumer H, Ferbert A et al. Intra-arterial thrombolytic therapy improves outcome in patients with acute vertebrobasilar occlusive disease. Stroke 1988; 19: 1216–22.
15. Brandt T, von Kummer R, Muller-Kuppers M, Hacke W. Thrombolytic therapy of acute basilar artery occlusion. Variables affecting recanalization and outcome. Stroke 1996; 27: 875–81.
16. Strbian D, Sairanen T, Silvennoinen H et al. Intravenous Thrombolysis of Basilar Artery Occlusion: Thrombus Length Versus Recanalization Success. Stroke 2014; 45 (6): 1733–8.
17. Lindsberg PJ, Mattle HP. Therapy of basilar artery occlusion: a systematic analysis comparing intra-arterial and intravenous thrombolysis. Stroke 2006; 37 (3): 922–8.
18. Broussalis E, Hitzl W, McCoy M et al. Comparison of endovascular treatment versus conservative medical treatment in patients with acute basilar artery occlusion. Vasc Endovascular Surg 2013; 47 (6): 429–37.
19. Schonewille WJ, Wijman CA, Michel P et al. Treatment and outcomes of acute basilar artery occlusion in the basilar artery international cooperation study (basics): A prospective registry study. Lancet Neurol 2009; 8: 724–30.
20. Pfefferkorn T, Mayer TE, Opherk C et al. Staged escalation therapy in acute basilar artery occlusion: Intravenous thrombolysis and on-demand consecutive endovascular mechanical thrombectomy: Preliminary experience in 16 patients. Stroke 2008; 39: 1496–500.
21. Martin-Schild S, Morales MM, Khaja AM et al. Is the drip-and-ship approach to delivering thrombolysis for acute ischemic stroke safe? J Emerg Med 2009.
22. Silverman IE, Beland DK, Chhabra J, McCullough LD. The "Drip-and-ship" Approach: Starting iv t-pa for acute ischemic stroke at outside hospitals prior to transfer to a regional stroke center. Conn Med 2005; 69: 613–20.
23. Pfefferkorn T, Holtmannspotter M, Schmidt C et al. Drip, ship, and retrieve: Cooperative recanalization therapy in acute basilar artery occlusion. Stroke 2010; 5–6: 722–6.
24. Mayer TE, Hamann GF, Brueckmann HJ. Treatment of basilar artery embolism with a mechanical extraction device: Necessity of flow reversal. Stroke 2002; 33: 2232–5.
Авторы
А.П.Толмачев*, К.В.Анисимов, Н.А.Шамалов
ГБОУ ВПО Российский национальный исследовательский медицинский университет им. Н.И.Пирогова Минздрава России. 117997, Россия, Москва, ул. Островитянова, д. 1
*tap87@mail.ru
N.I.Pirogov Russian National Research Medical University of the Ministry of Health of the Russian Federation. 117997, Russian Federation, Moscow, ul. Ostrovitianova, d. 1
*tap87@mail.ru
ГБОУ ВПО Российский национальный исследовательский медицинский университет им. Н.И.Пирогова Минздрава России. 117997, Россия, Москва, ул. Островитянова, д. 1
*tap87@mail.ru
________________________________________________
N.I.Pirogov Russian National Research Medical University of the Ministry of Health of the Russian Federation. 117997, Russian Federation, Moscow, ul. Ostrovitianova, d. 1
*tap87@mail.ru
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