medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/2079-701X-2015-10-4-5medsovet-264Research ArticleЦЕРЕБРОВАСКУЛЯРНЫЕ ЗАБОЛЕВАНИЯCEREBROVASCULAR DISEASESВнутриартериальная реперфузионная терапия у пациентов с острым ишемическим инсультомIntra-arterial reperfusion therapy in patients with acute ischemic strokeВолодюхинМ. Ю.VolodyuhinM. Y.noemail@neicon.ruХасановаД. Р.KhasanovaD. R.noemail@neicon.ruДёминТ. В.DeminT. V.noemail@neicon.ruЗагидуллинБ. И.ZagidullinB. I.noemail@neicon.ruМусинШ. Г.MusinS. G.noemail@neicon.ruШарафутдиновМ. Р.SharafutdinovM. R.noemail@neicon.ruМежрегиональный клинико-диагностический центр; Больница скорой медицинской помощиРоссияInterregional Clinical Diagnostic Center; Emergency Care HospitalRussian Federation20153012201501045Copyright © Володюхин М.Ю., Хасанова Д.Р., Дёмин Т.В., Загидуллин Б.И., Мусин Ш.Г., Шарафутдинов М.Р., 20152015Володюхин М.Ю., Хасанова Д.Р., Дёмин Т.В., Загидуллин Б.И., Мусин Ш.Г., Шарафутдинов М.Р.Volodyuhin M.Y., Khasanova D.R., Demin T.V., Zagidullin B.I., Musin S.G., Sharafutdinov M.R.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-sovet.pro/jour/article/view/264

В данной работе представлен опыт выполнения внутриартериальных методов реваскуляризации у пациентов с острым ишемическим инсультом (ОИИ) в бассейне средней мозговой артерии, выполненных в двух лечебных учреждениях Республики Татарстан (ГАУЗ «Межрегиональный клинико-диагностический центр», Казань, ГАУЗ «Больница скорой медицинской помощи», Набережные Челны). Предложен алгоритм отбора пациентов, позволяющий оптимизировать применение инвазивной реперфузионной терапии у больных с ОИИ в бассейне СМА в рутинной клинической практике.

The article tells about the experience of intra-arterial revascularization in patients with acute ischemic stroke (AIS) in the middle cerebral artery performed at two hospitals of the Republic of Tatarstan (Interregional Clinical and Diagnostic Center in Kazan and Emergency Care Hospital in Naberezhnye Chelny). An algorithm for the selection of patients is suggested which allows to optimize invasive reperfusion therapy in patients with AIS in the MCA in routine clinical practice.

ишемический инсультэндоваскулярная реперфузионная терапияendovascular reperfusion therapyReferencesPowers W, Derdeyn C, BiLLerJ, Coffey C, Hoh B, Jauch E, Johnston K, Johnston C, KhaLessi A, KidweLL C, Meschia J, OvbiageLe B. Guidelines for the earLy management of patients with acute ischemic stroke regarding endovascuLar treatment. A GuideLine for heaLthcare professionaLs from the American Heart Association/ American Stroke Association pubLished onLine June 29, 2015AHA/ASA.Powers W, Derdeyn C, BiLLerJ, Coffey C, Hoh B, Jauch E, Johnston K, Johnston C, KhaLessi A, KidweLL C, Meschia J, OvbiageLe B. Guidelines for the earLy management of patients with acute ischemic stroke regarding endovascuLar treatment. A GuideLine for heaLthcare professionaLs from the American Heart Association/ American Stroke Association pubLished onLine June 29, 2015AHA/ASA.Zeumer H, Hacke W, RingeLstein EB. Local intraarteriaL thromboLysis in vertebrobasiLar thromboemboLic disease. Am. J. Neuroradiol, 1983. 4: 401-404.Zeumer H, Hacke W, RingeLstein EB. Local intraarteriaL thromboLysis in vertebrobasiLar thromboemboLic disease. Am. J. Neuroradiol, 1983. 4: 401-404.FurLan A, Higashida R, WeschLer L, et aL. Intra-arteriaL prourokinase for acute ischemic stroke: The PROACT II Study: a randomized controLLed triaL. JAMA, 1999. 282: 2003-2011.FurLan A, Higashida R, WeschLer L, et aL. Intra-arteriaL prourokinase for acute ischemic stroke: The PROACT II Study: a randomized controLLed triaL. JAMA, 1999. 282: 2003-2011.Chimowitz MI. EndovascuLar treatment for acute ischemic stroke stiLL unproven. N. Engl. J. Med, 2013. 368: 952-5.Chimowitz MI. EndovascuLar treatment for acute ischemic stroke stiLL unproven. N. Engl. J. Med, 2013. 368: 952-5.Mortimer A, Bradiey M, Renowde S. EndovascuLar therapy in hyperacute ischaemic stroke: history and current. Interventional neuroradiology, 2013. 19: 506-518.Mortimer A, Bradiey M, Renowde S. EndovascuLar therapy in hyperacute ischaemic stroke: history and current. Interventional neuroradiology, 2013. 19: 506-518.Yoneyama T, Nakano S, Iseda T et aLL. Combined direct percutaneous transLuminaL angiopLasty and Low-dose native tissue pLasminogen activator therapy for acute emboLic middLe cerebraL artery trunk occLusion. Am. J. Neuroradiol, 2002. 23: 277-281.Yoneyama T, Nakano S, Iseda T et aLL. Combined direct percutaneous transLuminaL angiopLasty and Low-dose native tissue pLasminogen activator therapy for acute emboLic middLe cerebraL artery trunk occLusion. Am. J. Neuroradiol, 2002. 23: 277-281.BrekenfeLd C, Schroth G, EL-Koussy M. MechanicaL ThromboemboLectomy for Acute ischemic stroke: comparison of the catch thromboectomy device and the Merci retriever in vivo. Stroke, 2008. 39: 1213-1219.BrekenfeLd C, Schroth G, EL-Koussy M. MechanicaL ThromboemboLectomy for Acute ischemic stroke: comparison of the catch thromboectomy device and the Merci retriever in vivo. Stroke, 2008. 39: 1213-1219.Houdart Ch, Mounaver R, Saint-Maurice C et aLL. Thromboaspiration in the basiLar artery: report of two case. Am. J. Neuroradiol, 2002. 23: 282-284.Houdart Ch, Mounaver R, Saint-Maurice C et aLL. Thromboaspiration in the basiLar artery: report of two case. Am. J. Neuroradiol, 2002. 23: 282-284.Berkhemer O, Fransen P, Beumer D et aL. A randomized triaL of intraarteriaL treatment for acute ischemic stroke. N. Engl. J. Med, 2015. 372: 11-20.Berkhemer O, Fransen P, Beumer D et aL. A randomized triaL of intraarteriaL treatment for acute ischemic stroke. N. Engl. J. Med, 2015. 372: 11-20.GoyaL M, Demchuk A, Menon B et aL. Randomized assessment of rapid endovascuLar treatment of ischemic stroke. N. Engl. J. Med, 2015. 15: 2-11.GoyaL M, Demchuk A, Menon B et aL. Randomized assessment of rapid endovascuLar treatment of ischemic stroke. N. Engl. J. Med, 2015. 15: 2-11.CampbeLL B, MitcheLL P, KLeinig T et aL. EndovascuLar therapy for ischemic stroke with perfusion-imaging seLection. N. Engl. J. Med, 2015. 15: 9-35.CampbeLL B, MitcheLL P, KLeinig T et aL. EndovascuLar therapy for ischemic stroke with perfusion-imaging seLection. N. Engl. J. Med, 2015. 15: 9-35.KidweLL C, Jahan R, Gornbein J et aLL. A triaL of imaging seLection and endovascuLar treatment for ischemic stroke. Engl. J. Med, 2013. 368: 914-23.KidweLL C, Jahan R, Gornbein J et aLL. A triaL of imaging seLection and endovascuLar treatment for ischemic stroke. Engl. J. Med, 2013. 368: 914-23.Rai T, Raghuram K, Carpenter S, Domico J, Hobbs G. Pre-intervention cerebraL bLood voLume predict outcomes in patients undergoing endovascuLar therapy for acute ischemic stroke. J. Neuro. Intervent. Surg, 2011. 12: 1234-1240.Rai T, Raghuram K, Carpenter S, Domico J, Hobbs G. Pre-intervention cerebraL bLood voLume predict outcomes in patients undergoing endovascuLar therapy for acute ischemic stroke. J. Neuro. Intervent. Surg, 2011. 12: 1234-1240.Turk A, Magarick J, Frei D, Fargen K, Chaudry I, HoLmstedt C, NichoLas J, Mocco J, Turner R, HuddLe D, Loy D, BeLLon R, DooLey G, Adams R, WhaLey M, FanaLe C, Jauch E. CT perfusion-guid-ed patient seLection for endovascuLar recanaLi-zation in acute ishemic stroke: a muLticenter study. J. NeuroIntervent. Surg, 2013. 5: 523-527.Turk A, Magarick J, Frei D, Fargen K, Chaudry I, HoLmstedt C, NichoLas J, Mocco J, Turner R, HuddLe D, Loy D, BeLLon R, DooLey G, Adams R, WhaLey M, FanaLe C, Jauch E. CT perfusion-guid-ed patient seLection for endovascuLar recanaLi-zation in acute ishemic stroke: a muLticenter study. J. NeuroIntervent. Surg, 2013. 5: 523-527.Yoo A, Verduzco L, Schaefer P, Hirsch J, Rabinov J, GonzaLez R. MRI-based seLection for intra-arteriaL stroke therapy: vaLue of pretreatment diffusion-weighted imaging Lesion voLume in seLecting patients with acute stroke who wiLL benefit from earLy recanaLization. Stroke, 2009. 40: 2046-2054.Yoo A, Verduzco L, Schaefer P, Hirsch J, Rabinov J, GonzaLez R. MRI-based seLection for intra-arteriaL stroke therapy: vaLue of pretreatment diffusion-weighted imaging Lesion voLume in seLecting patients with acute stroke who wiLL benefit from earLy recanaLization. Stroke, 2009. 40: 2046-2054.CostaLat V, Machi P, Lobotesis K, MaLdonado I, VendreLL J, RiqueLme C, Mourand I, MiLhaud D, Heroum C, PerrigauLt P, Arquizan C, Bonafe A. Rescue, combined, and stand-aLone thrombec-tomy in the management of Large vesseL occLusion stroke using the soLitaire device: a prospective 50-patient singLe-center study: timing, safety, and efficacy. Stroke, 2011. 42: 1929-1935.CostaLat V, Machi P, Lobotesis K, MaLdonado I, VendreLL J, RiqueLme C, Mourand I, MiLhaud D, Heroum C, PerrigauLt P, Arquizan C, Bonafe A. Rescue, combined, and stand-aLone thrombec-tomy in the management of Large vesseL occLusion stroke using the soLitaire device: a prospective 50-patient singLe-center study: timing, safety, and efficacy. Stroke, 2011. 42: 1929-1935.Sandhu G, Parikh P, Hsu D, BLackham K, Tarr R, Sunshin J. Outcomes of intra-arteriaL thrombo- Lytic treatment in acute ischemic stroke patients with a matched defecton diffusion and perfusion MR images. J. Neuro. Intervent. Surg, 2012. 4: 105-109.Sandhu G, Parikh P, Hsu D, BLackham K, Tarr R, Sunshin J. Outcomes of intra-arteriaL thrombo- Lytic treatment in acute ischemic stroke patients with a matched defecton diffusion and perfusion MR images. J. Neuro. Intervent. Surg, 2012. 4: 105-109.Brinjikji W, Rabinstein A, KaLLmes D. CLoft H. Outcomes with endovascuLar emboLectomy therapy for acute ischemic stroke: a study of the nationaL inpatient sampLe: 2006 to 2008. Stroke, 2011. 42: 1648-1652.Brinjikji W, Rabinstein A, KaLLmes D. CLoft H. Outcomes with endovascuLar emboLectomy therapy for acute ischemic stroke: a study of the nationaL inpatient sampLe: 2006 to 2008. Stroke, 2011. 42: 1648-1652.Fargen K, Chaudry I, Turner R, Bennett JA, AquiLLa Turk, Mocco J. A noveL cLinicaL and imaging based score for predicting outcome prior to endovascuLar treatment of acute ischemic stroke. J. Neuro. Intervent. Surg, 2013. 5: 38-4.Fargen K, Chaudry I, Turner R, Bennett JA, AquiLLa Turk, Mocco J. A noveL cLinicaL and imaging based score for predicting outcome prior to endovascuLar treatment of acute ischemic stroke. J. Neuro. Intervent. Surg, 2013. 5: 38-4.Hussein M, Georgiadis L, Vazquez G, MiLey JT, Vazquez G, Memon MZ, Mohammad YM, Christoforidis GA, Tariq N, Oureshi AI. Occurrence and predictors of futiLe recanaLi-zation foLLowing endovascuLar treatment among patients with acute ischemic stroke: a muLticenter study. Am. J. Neuroradiol, 2010. 31: 454-458.Hussein M, Georgiadis L, Vazquez G, MiLey JT, Vazquez G, Memon MZ, Mohammad YM, Christoforidis GA, Tariq N, Oureshi AI. Occurrence and predictors of futiLe recanaLi-zation foLLowing endovascuLar treatment among patients with acute ischemic stroke: a muLticenter study. Am. J. Neuroradiol, 2010. 31: 454-458.Daniere F, Lobotesis K, Machi P, Eker O, Lobotesis K, Machi P, Mourand I, RiqueLme C, Ayrignac X, VendreLL JF, Gascou G, FendeLeur J, DargazanLi C, Schaub R, BruneL H, Arquizan C, Bonafe A, CostaLat V. Patient seLection for stroke endovascuLar therapy DWI-ASPECTS threshoLds shouLd vary among age groups: insights from the RECOST study. Am. J. Neuroradiol, 2015. 36: 32-39.Daniere F, Lobotesis K, Machi P, Eker O, Lobotesis K, Machi P, Mourand I, RiqueLme C, Ayrignac X, VendreLL JF, Gascou G, FendeLeur J, DargazanLi C, Schaub R, BruneL H, Arquizan C, Bonafe A, CostaLat V. Patient seLection for stroke endovascuLar therapy DWI-ASPECTS threshoLds shouLd vary among age groups: insights from the RECOST study. Am. J. Neuroradiol, 2015. 36: 32-39.Khasanova D, VoLodukhin M, Demin T, Sadaekova N, Faizava A. InfLuence of the voLume of ischemia on the resuLts of intervention methods of treatment acute cerebraL infarction. Interventional Neuroradiology, 2011. 17: 193.Khasanova D, VoLodukhin M, Demin T, Sadaekova N, Faizava A. InfLuence of the voLume of ischemia on the resuLts of intervention methods of treatment acute cerebraL infarction. Interventional Neuroradiology, 2011. 17: 193.Jayaraman М, Hussain M, Abruzzo T et aL. EmboLectomy for stroke with emergent Large vesseL occLusion: report of the standards and guideLines committee of the Society of Neuro InterventionaL Surgery. J. Neuro Intervent. Surg, 2015. 7: 316-321.Jayaraman М, Hussain M, Abruzzo T et aL. EmboLectomy for stroke with emergent Large vesseL occLusion: report of the standards and guideLines committee of the Society of Neuro InterventionaL Surgery. J. Neuro Intervent. Surg, 2015. 7: 316-321.

The authors declare that there are no conflicts of interest present.