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Biomedicines
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Acute Ischemic Stroke: From Imaging Diagnosis to the Latest Treatment...
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Acute Ischemic Stroke: From Imaging Diagnosis to the Latest Treatment Strategy

A special issue of Biomedicines (ISSN 2227-9059). This special issue belongs to the section "Neurobiology and Clinical Neuroscience".

Deadline for manuscript submissions: closed (30 December 2023) | Viewed by 16196

Special Issue Editor

Prof. Dr. Sergio Lucio Vinci

E-Mail Website
Guest Editor
Department of Biomedical Sciences and Morphological and Functional Imaging, University of Messina, 98100 Messina, Italy
Interests: neuroradiology; neuroimaging; interventional neurovascular treatment; cerebrovascular disease; acute ischemic stroke; cerebral aneurysms; brain arteriovenous malformations; brain dural fistula; brain tumors; angiography

Special Issue Information

Dear Colleagues,

Acute ischemic stroke is a disease with very high mortality and morbidity rates.

Appropriate management can significantly change the outcome for many patients. A multidisciplinary team is essential in the early recognition of stroke onset symptoms. Neuroimaging plays a central role in making the diagnosis, recognizing cerebral artery occlusions and planning targeted therapeutic strategies.

The primary goal is a rapid revascularization and limiting secondary neuronal injury.

Acute ischemic stroke treatment involves a pharmacological approach and endovascular strategy, which can be administered alone or in combination. The first one utilizes intravenous thrombolytic agents in the acute phase, or the best medical therapy. Endovascular treatment consists of using different types of devices, such as stent retrievers and/or aspiration catheters, in mechanical thrombectomy to obtain vessel recanalization.

The aim of this Special Issue is to focus on the management of acute ischemic stroke, from the clinical and neuroradiologic evaluation to the proposal of several different treatments.

We appreciate all contributions which could widen the radiological point of view of ischemic stroke disease, including those on neuroimaging optimization strategies, diagnostic innovations, novelties in treatment opportunities and future directions in the field.

Prof. Dr. Sergio Lucio Vinci
Guest Editor

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Keywords

  • acute ischemic stroke
  • cerebrovascular disease
  • stroke onset symptoms
  • neuroimaging
  • neuroradiology
  • endovascular thrombectomy
  • neurovascular treatment
  • revascularization
  • fibrinolytic therapy

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Published Papers (2 papers)

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Review

59 pages, 1910 KiB  
Review
Integrative Approaches in Acute Ischemic Stroke: From Symptom Recognition to Future Innovations
by Vicentiu Mircea Saceleanu, Corneliu Toader, Horia Ples, Razvan-Adrian Covache-Busuioc, Horia Petre Costin, Bogdan-Gabriel Bratu, David-Ioan Dumitrascu, Andrei Bordeianu, Antonio Daniel Corlatescu and Alexandru Vlad Ciurea
Biomedicines 2023, 11(10), 2617; https://doi.org/10.3390/biomedicines11102617 - 23 Sep 2023
Cited by 48 | Viewed by 9944
Abstract
Among the high prevalence of cerebrovascular diseases nowadays, acute ischemic stroke stands out, representing a significant worldwide health issue with important socio-economic implications. Prompt diagnosis and intervention are important milestones for the management of this multifaceted pathology, making understanding the various stroke-onset symptoms [...] Read more.
Among the high prevalence of cerebrovascular diseases nowadays, acute ischemic stroke stands out, representing a significant worldwide health issue with important socio-economic implications. Prompt diagnosis and intervention are important milestones for the management of this multifaceted pathology, making understanding the various stroke-onset symptoms crucial. A key role in acute ischemic stroke management is emphasizing the essential role of a multi-disciplinary team, therefore, increasing the efficiency of recognition and treatment. Neuroimaging and neuroradiology have evolved dramatically over the years, with multiple approaches that provide a higher understanding of the morphological aspects as well as timely recognition of cerebral artery occlusions for effective therapy planning. Regarding the treatment matter, the pharmacological approach, particularly fibrinolytic therapy, has its merits and challenges. Endovascular thrombectomy, a game-changer in stroke management, has witnessed significant advances, with technologies like stent retrievers and aspiration catheters playing pivotal roles. For select patients, combining pharmacological and endovascular strategies offers evidence-backed benefits. The aim of our comprehensive study on acute ischemic stroke is to efficiently compare the current therapies, recognize novel possibilities from the literature, and describe the state of the art in the interdisciplinary approach to acute ischemic stroke. As we aspire for holistic patient management, the emphasis is not just on medical intervention but also on physical therapy, mental health, and community engagement. The future holds promising innovations, with artificial intelligence poised to reshape stroke diagnostics and treatments. Bridging the gap between groundbreaking research and clinical practice remains a challenge, urging continuous collaboration and research. Full article
(This article belongs to the Special Issue Acute Ischemic Stroke: From Imaging Diagnosis to the Latest Treatment Strategy)
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20 pages, 4581 KiB  
Review
Nanotechnology in Stroke: New Trails with Smaller Scales
by Karlo Toljan, Anushruti Ashok, Vinod Labhasetwar and M. Shazam Hussain
Biomedicines 2023, 11(3), 780; https://doi.org/10.3390/biomedicines11030780 - 4 Mar 2023
Cited by 13 | Viewed by 5458
Abstract
Stroke is a leading cause of death, long-term disability, and socioeconomic costs, highlighting the urgent need for effective treatment. During acute phase, intravenous administration of recombinant tissue plasminogen activator (tPA), a thrombolytic agent, and endovascular thrombectomy (EVT), a mechanical intervention to retrieve clots, [...] Read more.
Stroke is a leading cause of death, long-term disability, and socioeconomic costs, highlighting the urgent need for effective treatment. During acute phase, intravenous administration of recombinant tissue plasminogen activator (tPA), a thrombolytic agent, and endovascular thrombectomy (EVT), a mechanical intervention to retrieve clots, are the only FDA-approved treatments to re-establish cerebral blood flow. Due to a short therapeutic time window and high potential risk of cerebral hemorrhage, a limited number of acute stroke patients benefit from tPA treatment. EVT can be performed within an extended time window, but such intervention is performed only in patients with occlusion in a larger, anatomically more proximal vasculature and is carried out at specialty centers. Regardless of the method, in case of successful recanalization, ischemia-reperfusion injury represents an additional challenge. Further, tPA disrupts the blood-brain barrier integrity and is neurotoxic, aggravating reperfusion injury. Nanoparticle-based approaches have the potential to circumvent some of the above issues and develop a thrombolytic agent that can be administered safely beyond the time window for tPA treatment. Different attributes of nanoparticles are also being explored to develop a multifunctional thrombolytic agent that, in addition to a thrombolytic agent, can contain therapeutics such as an anti-inflammatory, antioxidant, neuro/vasoprotective, or imaging agent, i.e., a theragnostic agent. The focus of this review is to highlight these advances as they relate to cerebrovascular conditions to improve clinical outcomes in stroke patients. Full article
(This article belongs to the Special Issue Acute Ischemic Stroke: From Imaging Diagnosis to the Latest Treatment Strategy)
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