Research Progress of Hemorrhagic Transformation after Endovascular Treatment in Acute Ischemic Stroke

doi:10.3969/j.issn.1673-5765.2023.09.014

Abstract

Abstract: The keypoint to the treatment of acute ischemic stroke is to timely recanalize the occluded artery, restore blood flow in the ischemic tissue, and save the ischemic penumbra. Up to now, endovascular treatment represented by mechanical thrombectomy and stent implantation has become effective treatment for acute ischemic stroke, but hemorrhagic transformation is still a catastrophic complication of endovascular treatment, and is closely related to neurological deterioration and poor functional outcomes. Therefore, it is crucial for clinicians to deepen their understandings of hemorrhagic transformation. Based on the relevant guidelines and the latest studies, this paper aims to make a comprehensive review about hemorrhagic transformation after endovascular treatment of acute ischemic stroke, discusses the pathophysiological mechanism, risk factors, predictors and prevention and treatment strategies of hemorrhagic transformation, so as to provide reference for early prediction, prevention and treatment of hemorrhagic transformation.

出血转化是AIS血管内治疗的严重并发症，本文旨在为出血转化的早期预测及防治提供临床参考依据。

Key words: Hemorrhagic transformation; Acute ischemic stroke; Endovascular treatment; Prediction; Prevention and treatment

摘要： 急性缺血性卒中治疗的关键在于尽早开通闭塞的血管，恢复缺血区域的血流灌注，挽救缺血半暗带。目前以机械取栓、支架置入为代表的血管内治疗已成为急性缺血性卒中的有效治疗方法，但出血转化仍是血管内治疗的灾难性并发症，并与神经功能恶化和较差的功能预后密切相关。因此，提高临床医师对出血转化的认识至关重要。现结合相关指南和最新研究进展，对急性缺血性卒中血管内治疗后出血转化的研究进展进行综述，探讨出血转化的病理生理机制、危险因素、预测指标及防治策略，为早期预测及防治出血转化提供参考。

关键词: 出血转化; 急性缺血性卒中; 血管内治疗; 预测; 防治

LU Jing, LI Chuanfa, ZHANG Daqi, CHEN Rong, LI Qifu. Research Progress of Hemorrhagic Transformation after Endovascular Treatment in Acute Ischemic Stroke[J]. Chinese Journal of Stroke, 2023, 18(9): 1065-1072.

陆靖, 李传发, 张大启, 陈蓉, 李其富. 急性缺血性卒中血管内治疗后出血转化的研究进展[J]. 中国卒中杂志, 2023, 18(9): 1065-1072.

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