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J Clin Neurosci. 2019 Nov;69:289-291. doi: 10.1016/j.jocn.2019.08.001. Epub 2019 Aug 17.

Neuroprotection for ischemic stroke in the endovascular era: A brief report on the future of intra-arterial therapy.

Author information

1
Department of Radiology, University of Michigan, Ann Arbor, MI, United States. Electronic address: jgriauz@med.umich.edu.
2
Department of Neurosurgery, Texas Children's Hospital, Houston, TX, United States. Electronic address: vijay.ravindra@hsc.utah.edu.
3
Department of Radiology, University of Michigan, Ann Arbor, MI, United States; Department of Neurosurgery, University of Michigan, Ann Arbor, MI, United States. Electronic address: neerajc@med.umich.edu.
4
Department of Radiology, University of Michigan, Ann Arbor, MI, United States; Department of Neurosurgery, University of Michigan, Ann Arbor, MI, United States. Electronic address: gemmete@med.umich.edu.
5
Department of Neurosurgery, University of Michigan, Ann Arbor, MI, United States. Electronic address: adityap@med.umich.edu.

Abstract

Mechanical thrombectomy is now at the forefront of the treatment of large vessel acute ischemic stroke (AIS). Selective intra-arterial (IA) access has opened a new avenue for neuroprotection in AIS that has the potential to maximize local benefit while minimizing systemic effects. On a cellular level, neuroprotective strategies are aimed at reducing inflammation and free-radical formation, maintaining blood-brain barrier fidelity, and preventing cellular death. Strategies under investigation include IA infusion of neuroprotective agents, IA administration of stem cells, and selective IA hypothermia. In this technical report, we briefly discuss pathologic mechanisms in AIS and highlight potential neuroprotective strategies that are administered selectively via the IA route.

KEYWORDS:

Hypothermia; Intra-arterial therapy; Ischemic stroke; Neuroprotection; Stem cells

PMID:
31431407
DOI:
10.1016/j.jocn.2019.08.001
[Indexed for MEDLINE]

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