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<article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xmlns:ali="http://www.niso.org/schemas/ali/1.0/" article-type="other" dtd-version="1.2" xml:lang="en"><front><journal-meta><journal-id journal-id-type="publisher-id">Annals of Clinical and Experimental Neurology</journal-id><journal-title-group><journal-title xml:lang="en">Annals of Clinical and Experimental Neurology</journal-title><trans-title-group xml:lang="ru"><trans-title>Анналы клинической и экспериментальной неврологии</trans-title></trans-title-group></journal-title-group><issn publication-format="print">2075-5473</issn><issn publication-format="electronic">2409-2533</issn><publisher><publisher-name xml:lang="en">Eco-Vector</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="publisher-id">682</article-id><article-id pub-id-type="doi">10.25692/ACEN.2020.3.5</article-id><article-categories><subj-group subj-group-type="toc-heading" xml:lang="en"><subject>Original articles</subject></subj-group><subj-group subj-group-type="toc-heading" xml:lang="ru"><subject>Оригинальные статьи</subject></subj-group><subj-group subj-group-type="article-type"><subject>Unknown</subject></subj-group></article-categories><title-group><article-title xml:lang="en">Progressive ischaemic stroke: the difficulty in choosing antithrombotic therapy</article-title><trans-title-group xml:lang="ru"><trans-title>Прогрессирующий ишемический инсульт: проблема выбора антитромботической терапии</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author"><name-alternatives><name xml:lang="en"><surname>Shirokov</surname><given-names>Evgenii A.</given-names></name><name xml:lang="ru"><surname>Широков</surname><given-names>Евгений Алексеевич</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><email>evg-747747@yandex.ru</email><xref ref-type="aff" rid="aff1"/></contrib><contrib contrib-type="author"><name-alternatives><name xml:lang="en"><surname>Lomakin</surname><given-names>Nikita V.</given-names></name><name xml:lang="ru"><surname>Ломакин</surname><given-names>Никита Валериевич</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><email>evg-747747@yandex.ru</email><xref ref-type="aff" rid="aff2"/></contrib><contrib contrib-type="author"><name-alternatives><name xml:lang="en"><surname>Buryachkovskaya</surname><given-names>Luydmila I.</given-names></name><name xml:lang="ru"><surname>Бурячковская</surname><given-names>Людмила Ивановна</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><email>evg-747747@yandex.ru</email><xref ref-type="aff" rid="aff3"/></contrib></contrib-group><aff-alternatives id="aff1"><aff><institution xml:lang="en">S.M. Kirov Military Medical Academy (Moscow branch)</institution></aff><aff><institution xml:lang="ru">ФГБВОУ «Военно-медицинская академия им. С.М. Кирова» (Московский филиал)</institution></aff></aff-alternatives><aff-alternatives id="aff2"><aff><institution xml:lang="en">Central Clinical Hospital, Presidential Affairs Department</institution></aff><aff><institution xml:lang="ru">ФГБУ «Центральная клиническая больница с поликлиникой» Управления делами Президента РФ</institution></aff></aff-alternatives><aff-alternatives id="aff3"><aff><institution xml:lang="en">National Medical Cardiology Center</institution></aff><aff><institution xml:lang="ru">Институт экспериментальной кардиологии ФГБУ «Национальный медицинский исследовательский центр кардиологии» МЗ РФ</institution></aff></aff-alternatives><pub-date date-type="pub" iso-8601-date="2020-09-14" publication-format="electronic"><day>14</day><month>09</month><year>2020</year></pub-date><volume>14</volume><issue>3</issue><issue-title xml:lang="en"/><issue-title xml:lang="ru"/><fpage>36</fpage><lpage>42</lpage><history><date date-type="received" iso-8601-date="2020-09-14"><day>14</day><month>09</month><year>2020</year></date></history><permissions><copyright-statement xml:lang="en">Copyright ©; 2020, Shirokov E.A., Lomakin N.V., Buryachkovskaya L.I.</copyright-statement><copyright-statement xml:lang="ru">Copyright ©; 2020, Shirokov E.A., Lomakin N.V., Buryachkovskaya L.I.</copyright-statement><copyright-year>2020</copyright-year><copyright-holder xml:lang="en">Shirokov E.A., Lomakin N.V., Buryachkovskaya L.I.</copyright-holder><copyright-holder xml:lang="ru">Shirokov E.A., Lomakin N.V., Buryachkovskaya L.I.</copyright-holder><ali:free_to_read xmlns:ali="http://www.niso.org/schemas/ali/1.0/"/><license><ali:license_ref xmlns:ali="http://www.niso.org/schemas/ali/1.0/">https://creativecommons.org/licenses/by/4.0</ali:license_ref></license></permissions><self-uri xlink:href="https://annaly-nevrologii.com/pathID/article/view/682">https://annaly-nevrologii.com/pathID/article/view/682</self-uri><abstract xml:lang="en"><p>Progressive ischaemic stroke is a clinical form of unfavourable progression of an acute cerebrovascular accident, found in around 20% of cases during the acute period. The strategy and approach to managing patients with an apparent deterioration during the acute period of stroke have not been fully established. Various types of antithrombotic therapy are discussed in the literature, with the use of antiplatelet drugs considered the most promising.</p> <p>The authors analyse all types of antithrombotic therapy for progressive ischaemic stroke and examine in detail the only known case of late thrombolysis, which was performed in 1968.</p></abstract><trans-abstract xml:lang="ru"><p>Прогрессирующий ишемический инсульт — клинический вариант неблагоприятного течения острого нарушения мозгового кровообращения, который обнаруживается примерно в 20% случаев в остром периоде заболевания. Стратегия и тактика ведения больных с явным ухудшением в остром периоде инсульта окончательно не определены. В литературных источниках обсуждаются разные направления антитромботической терапии, среди которых применение антитромбоцитарных препаратов считается наиболее перспективным.</p> <p>Авторы статьи анализируют все направления антитромботической терапии при прогрессирующем ишемическом инсульте и детально рассматривают единственный известный случай позднего тромболизиса, который был выполнен в 1968 г.</p></trans-abstract><kwd-group xml:lang="en"><kwd>ischaemic stroke</kwd><kwd>progressive ischaemic brainstem stroke</kwd><kwd>acute period of ischaemic stroke</kwd><kwd>antithrombotic therapy</kwd><kwd>thrombosis</kwd><kwd>thrombolysis</kwd><kwd>plasminogen activators</kwd><kwd>fibrinolysin</kwd><kwd>anticoagulants</kwd><kwd>antiplatelet drugs</kwd></kwd-group><kwd-group xml:lang="ru"><kwd>ишемический инсульт</kwd><kwd>прогрессирующий стволовой ишемический инсульт</kwd><kwd>острый период ишемического инсульта</kwd><kwd>антитромботическая терапия</kwd><kwd>тромбоз</kwd><kwd>тромболизис</kwd><kwd>активаторы плазминогена</kwd><kwd>фибринолизин</kwd><kwd>антикоагулянты</kwd><kwd>антиагреганты</kwd></kwd-group><funding-group/></article-meta></front><body></body><back><ref-list><ref id="B1"><label>1.</label><mixed-citation>Chimowitz M.I. The Feinberg award lecture 2013: treatment of intracranial atherosclerosis: leaning from the past and planning for the future. Stroke 2013; 44: 2664–2669. DOI: 10.1161/STROKEAHA.113.001290. PMID: 23821232.</mixed-citation></ref><ref id="B2"><label>2.</label><citation-alternatives><mixed-citation xml:lang="en">Amarenco P., Lavallee P.C., Tavares L.M. et al. Five-year risk of stroke af- ter TIA or minor ischemic stroke. N Engl J Med 2018; 378: 2182–2190. DOI: 10.1056/NEJMoa1802712. PMID: 29766771.</mixed-citation><mixed-citation xml:lang="ru">Amarenco P., Lavallee P.C., Tavares L.M. et al. Five-year risk of stroke after TIA or minor ischemic stroke. N Engl J Med 2018; 378: 2182–2190. DOI: 10.1056/NEJMoa1802712. PMID: 29766771.</mixed-citation></citation-alternatives></ref><ref id="B3"><label>3.</label><citation-alternatives><mixed-citation xml:lang="en">Yang W., Wong K., Chen X. Intracranial atherosclerosis: from microscopy to high-resolution Magnetic Resonance Imaging. J Stroke 2017; 19: 249–260. DOI: 10.5853/jos.2016.01956. PMID: 28877564.</mixed-citation><mixed-citation xml:lang="ru">Yang W., Wong K., Chen X. Intracranial atherosclerosis: from microscopy to highresolution Magnetic Resonance Imaging. J Stroke 2017; 19: 249–260. DOI: 10.5853/jos.2016.01956. PMID: 28877564.</mixed-citation></citation-alternatives></ref><ref id="B4"><label>4.</label><citation-alternatives><mixed-citation xml:lang="en">Kernan W.N., Obliagele B., Black H.R. et al. Guidelines for the prevention of stroke in patients with stroke and transient ischemic attack: a guideline for health- care professionals from the American Heart Association/American Stroke Asso- ciation. Stroke 2014; 45: 2160–2236. DOI: 10.1161/STR.0000000000000024. PMID: 24788967.</mixed-citation><mixed-citation xml:lang="ru">Kernan W.N., Obliagele B., Black H.R. et al. Guidelines for the prevention of stroke in patients with stroke and transient ischemic attack: a guideline for healthcare professionals from the American Heart Association/American Stroke Asso- ciation. Stroke 2014; 45: 2160–2236. DOI: 10.1161/STR.0000000000000024. PMID: 24788967.</mixed-citation></citation-alternatives></ref><ref id="B5"><label>5.</label><citation-alternatives><mixed-citation xml:lang="en">Powers W.J., Rabinstein A.A., Ackerson T. et al. Guidelines for the early man- agement of patients with acute ischemic stroke: a guideline for healthcare pro- fessionals from the American Heart Association/American Stroke Association. Stroke 2018; 49: e46–e110. DOI: 10.1161/ STR.0000000000000158. PMID: 29367334.</mixed-citation><mixed-citation xml:lang="ru">Powers W.J., Rabinstein A.A., Ackerson T. et al. Guidelines for the early man- agement of patients with acute ischemic stroke: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke 2018; 49: e46–e110. DOI: 10.1161/ STR.0000000000000158. PMID: 29367334.</mixed-citation></citation-alternatives></ref><ref id="B6"><label>6.</label><citation-alternatives><mixed-citation xml:lang="en">Campbell B.C.V., Meretoja A., Donnan G.A., Davis S.M. Twenty-year his- tory of the evolution of stroke thrombolysis with intravenous alteplase to reduce long-term disability. Stroke 2015; 46: 2341–2346. DOI: 10.1161/STROKEA- HA.114.007564. PMID: 26152294.</mixed-citation><mixed-citation xml:lang="ru">Campbell B.C.V., Meretoja A., Donnan G.A., Davis S.M. Twenty-year history of the evolution of stroke thrombolysis with intravenous alteplase to reduce long-term disability. Stroke 2015; 46: 2341–2346. DOI: 10.1161/STROKEA- HA.114.007564. PMID: 26152294.</mixed-citation></citation-alternatives></ref><ref id="B7"><label>7.</label><mixed-citation>Muruet W., Rudd A., Wolfe C.D.A., Douiri A. Long-term survival after in- travenous thrombolysis for ischemic stroke. A propensity score-matched co- hort with up to 10-year follow-up. Stroke 2018; 49: 607–613. DOI: 10.1161/ STROKEAHA.117.019889. PMID: 29440582.</mixed-citation></ref><ref id="B8"><label>8.</label><mixed-citation>Ali L.K., Saver J.L. The ischemic stroke patient who worsens: new assessment and management approaches. Rev Neurol Dis 2007; 4: 85–91. PMID: 17609640.</mixed-citation></ref><ref id="B9"><label>9.</label><mixed-citation>Lesser T., Venth S., Lesser K. Progressive stroke in cases of common carotid occlusion — indication for revascularization. Zentralbl Chir 2008; 133: 374–375. DOI: 10.1055/s-2008-1076905. PMID: 18702024.</mixed-citation></ref><ref id="B10"><label>10.</label><mixed-citation>Birschel P., Ellul J., Barer D. Progressing stroke: towards an internationally agreed definition. Cerebrovasc Dis 2004; 17: 242–252. DOI: 10.1159/000076161. PMID: 14718754.</mixed-citation></ref><ref id="B11"><label>11.</label><mixed-citation>Emberson J., Lees K.R., Lyden P. et al. Effect of treatment delay, age, and stroke severity on the effects of intravenous thrombolysis with alteplase for acute ischaemic stroke: a meta-analysis of individual patient data from randomised trials. Lancet 2014; 384: 1929–1935. DOI: 10.1016/S0140-6736(14)60584-5. PMID: 25106063.</mixed-citation></ref><ref id="B12"><label>12.</label><mixed-citation>Fiehler J., Cognard C., Gallitelli M. et al. European Recommendations on Organisation of Interventional Care in Acute Stroke (EROICAS). Int J Stroke 2016; 11: 701–716. DOI: 10.1177/1747493016647735. PMID: 27462090.</mixed-citation></ref><ref id="B13"><label>13.</label><mixed-citation>Nakase T., Sasaki M., Ikeda Y., Suzuki A. Progressing small vessel pontine infarction includes different etiologies. Ann Clin Transl Neurol 2014; 1: 75–79. DOI: 10.1002/acn3.25. PMID: 25356386.</mixed-citation></ref><ref id="B14"><label>14.</label><mixed-citation>Cho Y.J., Koo J.S., Park J.M. et al. Factors associated with stroke progression in acute cerebral infarction. Int J Stroke 2008; 3: 405.</mixed-citation></ref><ref id="B15"><label>15.</label><citation-alternatives><mixed-citation xml:lang="en">Castillo J., Noya M. Mechanisms of progression of cerebral infarction. Neu- rologia 1999; 14: 2–12. PMID: 10379155.</mixed-citation><mixed-citation xml:lang="ru">Castillo J., Noya M. Mechanisms of progression of cerebral infarction. Neurologia 1999; 14: 2–12. PMID: 10379155.</mixed-citation></citation-alternatives></ref><ref id="B16"><label>16.</label><citation-alternatives><mixed-citation xml:lang="en">Milstone H. A factor in human normal blood which participates in strepto- coccal fibrinolysis. J Immunology 1941; 42: 109–115.</mixed-citation><mixed-citation xml:lang="ru">Milstone H. A factor in human normal blood which participates in streptococcal fibrinolysis. J Immunology 1941; 42: 109–115.</mixed-citation></citation-alternatives></ref><ref id="B17"><label>17.</label><citation-alternatives><mixed-citation xml:lang="en">Kline D.L. The purification and crystallization of plasminogen (profibrino- lysin). J Biol Chem 1953; 204: 949–955. PMID: 13117872.</mixed-citation><mixed-citation xml:lang="ru">Kline D.L. The purification and crystallization of plasminogen (profibrinolysin). J Biol Chem 1953; 204: 949–955. PMID: 13117872.</mixed-citation></citation-alternatives></ref><ref id="B18"><label>18.</label><citation-alternatives><mixed-citation xml:lang="en">Sussman B.J., Fitch T.S. Thrombolysis with fibrinolysin in cere- bral arterial occlusion. JAMA 1958; 167: 1705–1709. DOI: 10.1001/ jama.1958.02990310011002. PMID: 13563167.</mixed-citation><mixed-citation xml:lang="ru">Sussman B.J., Fitch T.S. Thrombolysis with fibrinolysin in cerebral arterial occlusion. JAMA 1958; 167: 1705–1709. DOI: 10.1001/ jama.1958.02990310011002. PMID: 13563167.</mixed-citation></citation-alternatives></ref><ref id="B19"><label>19.</label><citation-alternatives><mixed-citation xml:lang="en">Meyer J.S., Gilroy J., Barnhart M.I., Johnson J.F. Anticoagulants plus strep- tokinase therapy in progressive stroke. JAMA 1964; 189: 373. DOI: 10.1001/ jama.1964.03070050039011. PMID: 14163124.</mixed-citation><mixed-citation xml:lang="ru">Meyer J.S., Gilroy J., Barnhart M.I., Johnson J.F. Anticoagulants plus streptokinase therapy in progressive stroke. JAMA 1964; 189: 373. DOI: 10.1001/ jama.1964.03070050039011. PMID: 14163124.</mixed-citation></citation-alternatives></ref><ref id="B20"><label>20.</label><citation-alternatives><mixed-citation xml:lang="en">Schefer D.G., Chorjakov G.I. [The first experience of using fibrinolysin in an ambulance]. Vsesoyuznyy simpozium “Preduprezhdeniye i lecheniye mozgovykh insul’tov” Moscow, 1965: 34–35. (In Russ.)</mixed-citation><mixed-citation xml:lang="ru">Шефер Д.Г., Хорьяков Г.И. Первый опыт применения фибринолизина в условиях скорой помощи. Всесоюзный симпозиум «Предупреждение и лечение мозговых инсультов» М., 1965: 34–35.</mixed-citation></citation-alternatives></ref><ref id="B21"><label>21.</label><citation-alternatives><mixed-citation xml:lang="en">Chazov E.I., Andreyenko G.V. [The first experience of thrombosis therapy with domestic fibrinolysin]. Kardiologiya 1962; 4: 59–64. (In Russ.)</mixed-citation><mixed-citation xml:lang="ru">Чазов Е.И., Андреенко Г.В. Первый опыт терапии тромбоза отечественным фибринолизином. Кардиология 1962; 4: 59–64.</mixed-citation></citation-alternatives></ref><ref id="B22"><label>22.</label><citation-alternatives><mixed-citation xml:lang="en">Andreyenko G.V. [Fibrinolysis]. Moscow, 1967. 248 p. (In Russ.)</mixed-citation><mixed-citation xml:lang="ru">Андреенко Г.В. Фибринолиз. М., 1967. 248 с.</mixed-citation></citation-alternatives></ref><ref id="B23"><label>23.</label><mixed-citation>Mustard J.F., Murphy E.A., Downie H.G., Rowsell H.C. Heparin and thrombus formation: early suppression and late enhancement. Brit J Haematol 1963; 9: 548–551. DOI: 10.1111/j.1365-2141.1963.tb05479.x. PMID: 14076136.</mixed-citation></ref><ref id="B24"><label>24.</label><citation-alternatives><mixed-citation xml:lang="en">Kudrjashov B.A. [Biological problems of regulation of the liquid state of blood and its coagulation]. Moscow, 1975. 488 p. (In Russ.)</mixed-citation><mixed-citation xml:lang="ru">Кудряшов Б.А. Биологические проблемы регуляции жидкого состояния крови и ее свертывания. М., 1975. 488 с.</mixed-citation></citation-alternatives></ref><ref id="B25"><label>25.</label><mixed-citation>Rödén-Jüllig A., Britton M. Effectiveness of heparin treatment for progress- ing ischemic stroke: before and after study. J Intern Med 2000; 248: 287–291. DOI: 10.1046/j.1365-2796.2000.00727.x. PMID: 11086638.</mixed-citation></ref><ref id="B26"><label>26.</label><mixed-citation>Ma H., Campbell H., Parsons M. et al. Thrombolysis guided by perfusion imaging up to 9 hours after onset of stroke. N Engl J Med 2019; 380: 1795–1803. DOI: 10.1056/NEJMoa1813046. PMID: 31067369.</mixed-citation></ref><ref id="B27"><label>27.</label><mixed-citation>Kate M., Wannamaker R., Kamble H. et al. Penumbral imaging-based thrombolysis with tenecteplase is feasible up to 24 hours after symptom onset. J Stroke 2018; 20: 122–130. DOI: 10.5853/jos.2017.00178. PMID: 29402060.</mixed-citation></ref><ref id="B28"><label>28.</label><citation-alternatives><mixed-citation xml:lang="en">Hart R.G., Sharma M., Mundl H. et al. Rivaroxaban for stroke prevention af- ter embolic stroke of undetermined source. N Engl J Med 2018; 378: 2191–2201. DOI: 10.1056/NEJMoa1802686. PMID: 29766772.</mixed-citation><mixed-citation xml:lang="ru">Hart R.G., Sharma M., Mundl H. et al. Rivaroxaban for stroke prevention after embolic stroke of undetermined source. N Engl J Med 2018; 378: 2191–2201. DOI: 10.1056/NEJMoa1802686. PMID: 29766772.</mixed-citation></citation-alternatives></ref><ref id="B29"><label>29.</label><mixed-citation>Berberich A., Schneider C., Reiff T. et al. Dual antiplatelet therapy improves functional outcome in patients with progressive lacunar strokes. Stroke 2019; 50: 1007–1009. DOI: 10.1161/STROKEAHA.118.023789. PMID: 30841818.</mixed-citation></ref></ref-list></back></article>
