Mechanisms of fibrinolysis resistance and potential targets for thrombolysis in acute ischaemic stroke: lessons from retrieved stroke emboli  

作　　者：Waleed Brinjikji Oana Madalina Mereuta Daying Dai David F Kallmes Luis Savastano Yang Liu Shahid M Nimjee Raul G Nogueira Mehdi Abbasi Ramanathan Kadirvel 

机构地区：[1]Radiology,Mayo Clinic,Rochester,Minnesota,USA [2]Neurosurgery,Mayo Clinic,Rochester,Minnesota,USA [3]Neurosurgery,Ohio State University Medical Center,Columbus,Ohio,USA [4]Neurology,Emory University School of Medicine,Atlanta,Georgia,USA

出　　处：《Stroke & Vascular Neurology》2021年第4期658-667,共10页卒中与血管神经病学（英文）

基　　金：This work was supported by the National Institutes of Health grant number(R01 NS105853).

摘　　要：There has been growing interest and insight into the histological composition of retrieved stroke emboli.One of the main focuses of the stroke clot analysis literature has been the implications of clot composition on mechanical thrombectomy procedures.However,the holy grail of clot analysis may not be in the field of clot-device interaction,but rather,in understanding mechanisms of fibrinolysis resistance.The mechanisms underlying the low response to fibrinolytic therapy,even with the newer,more powerful agents,remain poorly understood.While factors such as embolus size,location and collateral status influence alteplase delivery and recanalisation rates;compositional analyses focused on histological and ultrastructural characteristics offer unique insights into mechanisms of alteplase resistance.In this review,we strive to provide comprehensive review of current knowledge on clot composition and ultrastructural analyses that help explain resistance to fibrinolysis.

关 键 词：FIBRIN HISTOLOGICAL RESISTANCE 

分 类 号：R743.3[医药卫生—神经病学与精神病学]