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首页> 美国卫生研究院文献>Journal of Cerebral Blood Flow Metabolism >Stroke neuroprotection revisited: Intra-arterial verapamil is profoundly neuroprotective in experimental acute ischemic stroke
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Stroke neuroprotection revisited: Intra-arterial verapamil is profoundly neuroprotective in experimental acute ischemic stroke

机译：再次探讨中风的神经保护作用：动脉内维拉帕米对实验性急性缺血性中风具有深远的神经保护作用

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While clinical trials have now solidified the role of thrombectomy in emergent large vessel occlusive stroke, additional therapies are needed to optimize patient outcome. Using our previously described experimental ischemic stroke model for evaluating adjunctive intra-arterial drug therapy after vessel recanalization, we studied the potential neuroprotective effects of verapamil. A calcium channel blocker, verapamil is often infused intra-arterially by neurointerventionalists to treat cerebral vasospasm. Such a direct route of administration allows for both focused targeting of stroke-impacted brain tissue and minimizes potential systemic side effects. Intra-arterial administration of verapamil at a flow rate of 2.5 µl/min and injection volume of 10 µl immediately after middle cerebral artery recanalization in C57/Bl6 mice was shown to be profoundly neuroprotective as compared to intra-arterial vehicle-treated stroke controls. Specifically, we noted a significant (P ≤ 0.05) decrease in infarct volume, astrogliosis, and cellular apoptosis as well as a significant increase in neuronal survival and functional outcome over seven days. Furthermore, intra-arterial administration of verapamil was well tolerated with no hemorrhage, systemic side effects, or increased mortality. Thus, verapamil administered intra-arterially immediately following recanalization in experimental ischemic stroke is both safe and neuroprotective and merits further study as a potential therapeutic adjunct to thrombectomy.
机译：尽管临床试验已经巩固了血栓切除术在急诊大血管闭塞性卒中中的作用，但仍需要其他疗法来优化患者预后。使用我们先前描述的实验性缺血性卒中模型评估血管再通后的辅助动脉内药物治疗，我们研究了维拉帕米的潜在神经保护作用。维拉帕米是钙通道阻滞剂，通常由神经介入专家通过动脉内输注来治疗脑血管痉挛。这种直接的给药途径既可以集中靶向中风影响的脑组织，又可以最大程度地减少潜在的全身性副作用。与动脉内媒介物治疗的中风对照相比，在C57 / Bl6小鼠中脑动脉再通后，以2.5μl/ min的流速动脉内给予维拉帕米和立即注入10μl的注射量具有深远的神经保护作用。具体来说，我们注意到在7天内，梗塞面积，星形胶质细胞增多症和细胞凋亡显着（P≤0.05）减少，神经元存活和功能结局显着增加。此外，维拉帕米的动脉内给药耐受性良好，没有出血，全身性副作用或死亡率增加。因此，在实验性缺血性卒中再通后立即在动脉内施用维拉帕米既安全又具有神经保护作用，值得进一步研究，作为血栓切除术的潜在治疗辅助手段。

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