Transformación hemorrágica en el tratamiento del ataque cerebrovascular isquémico agudo con trombólisis endovenosa, trombectomia mecánica o una combinación de las dos estrategias

Abstract

Introduction: Ischemic Stroke is a highly prevalent disease worldwide, although recently with the creation of therapies such as tissue plasminogen activator factor and mechanical thrombectomy, the burden of morbidity and mortality has improved among the population, however these therapies have brought with them the greatest presentation of a complication such as hemorrhagic transformation. Objective: Review the updated literature on the risk of hemorrhagic transformation of the different therapeutic modalities for acute ischemic stroke. Methods: A search of the Medline, Cochrane central, Science Direct, LILACS, Scielo databases was performed, taking into account the PICO strategy and using the following descriptors: "Acute Cerebrovascular Accident", Adult, "Fibrinolytic Therapy", "Clot Disruption, Mechanical ”,“ Intracranial Hemorrhage ”,“ Brain Hemorrhage ”, the search was limited to a period of 10 years from January 2010. Results: 114 results were obtained, 76 were discarded based on the title and summary review as they were not related to the problem question posed, 8 were later discarded as being in a language other than English and Spanish and 2 because they were in a non-human population, thus 30 articles were selected. Conclusions: Endovenous thrombolysis and mechanical thrombectomy or a combination of them have a comparable risk of hemorrhagic transformation, however this bibliographic review shows that more randomized clinical studies with more uniform eligibility criteria are required in order to make more homogeneous the comparison and analysis population. Key Words: “Acute Cerebrovascular Accident”, Adult, “Fibrinolytic Therapy”, “Clot Disruption, Mechanical”, “Intracranial Hemorrhage”, “Brain Hemorrhage”.

Introduction: Ischemic Stroke is a highly prevalent disease worldwide, although recently with the creation of therapies such as tissue plasminogen activator factor and mechanical thrombectomy, the burden of morbidity and mortality has improved among the population, however these therapies have brought with them the greatest presentation of a complication such as hemorrhagic transformation. Objective: Review the updated literature on the risk of hemorrhagic transformation of the different therapeutic modalities for acute ischemic stroke. Methods: A search of the Medline, Cochrane central, Science Direct, LILACS, Scielo databases was performed, taking into account the PICO strategy and using the following descriptors: "Acute Cerebrovascular Accident", Adult, "Fibrinolytic Therapy", "Clot Disruption, Mechanical ”,“ Intracranial Hemorrhage ”,“ Brain Hemorrhage ”, the search was limited to a period of 10 years from January 2010. Results: 114 results were obtained, 76 were discarded based on the title and summary review as they were not related to the problem question posed, 8 were later discarded as being in a language other than English and Spanish and 2 because they were in a non-human population, thus 30 articles were selected. Conclusions: Endovenous thrombolysis and mechanical thrombectomy or a combination of them have a comparable risk of hemorrhagic transformation, however this bibliographic review shows that more randomized clinical studies with more uniform eligibility criteria are required in order to make more homogeneous the comparison and analysis population. Key Words: “Acute Cerebrovascular Accident”, Adult, “Fibrinolytic Therapy”, “Clot Disruption, Mechanical”, “Intracranial Hemorrhage”, “Brain Hemorrhage”.