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Neuroprotective delivery platforms as an adjunct to mechanical thrombectomy
Robin M Babadjouni1, Brian P Walcott2, Qinghai Liu1
1Zilkha Neurogenetic Institute and.
Neurosurgical Focus
|April 4, 2017
Summary
Neuroprotective treatments for stroke have failed clinically. Combining advanced endovascular reperfusion with novel neuroprotective delivery platforms offers a promising new strategy for acute ischemic stroke treatment.
Area of Science:
- Neuroscience
- Neurology
- Clinical Medicine
Background:
- Numerous neuroprotective strategies show promise in preclinical stroke models but fail in clinical translation.
- Ineffective recanalization for large vessel occlusions and suboptimal neuroprotective agent delivery hinder clinical success.
Purpose of the Study:
- To review past and current neuroprotective strategies for acute stroke.
- To discuss delivery platforms and their potential integration with endovascular stroke treatment.
Main Methods:
- Literature review of preclinical and clinical stroke trials.
- Analysis of endovascular stroke trials and emerging revascularization technologies.
- Evaluation of neuroprotective agent delivery systems.
Main Results:
- Endovascular stroke trials have shifted treatment paradigms for large vessel occlusions.
- Advanced mechanical revascularization devices address previous treatment gaps.
- Combined endovascular reperfusion and neuroprotection is now feasible.
Conclusions:
- Integrating effective endovascular reperfusion with optimized neuroprotective delivery is a practical and potentially synergistic approach.
- Novel delivery platforms are crucial for the clinical success of neuroprotective therapies in acute stroke.
- This combined strategy could significantly improve outcomes for patients with large vessel occlusion stroke.
Keywords:
AIS = acute ischemic strokeAPC = activated protein CBM-MNC = bone marrow mononuclear cellDWI = diffusion-weighted imagingMCA = middle cerebral arteryNIHSS = National Institutes of Health Stroke Scaleacute ischemic strokemRS = modified Rankin Scalemechanical thrombectomyneuroprotectionrPerC = remote ischemic perconditioning (preconditioning)tPA = tissue plasminogen activator