Department of Neurology, National Medical Center, Seoul, Korea
ABSTRACT
So even though blood pressure changes are common following acute ischemic stroke, a long-standing debate exists regarding the management of immediately post-stroke hypertension or hypotension. Induced hypertension is early consideration as a method of maintaining or increasing cerebral perfusion to ischemic penumbra tissue, particularly in large vessel disease or hemodynamic compromise induced stroke. Many pharmacological agents have been tried for induced hypertension, including phenylephrine and norephinephrine. Although there were not large, randomised controlled trials of induced hypertension, limited human study suggests that blood pressure elevation may be useful in treatment of acute ischemic stroke. Partial aortic occlusion in small clinical research enhances cerebral perfusion with minimal blood pressure change. The proposed mechanism is collateral blood flow augmentation and salvage of ischemic penumbra tissue. The NeuroFloTM (CoAxia, Maple Grove, MN) catheter is specific endovascular device for partial aortic obstruction consists of dual balloons. NeuroFloTM partially restricts blood flow in the descending aorta, diverting blood flow from the lower extremities to increase of cerebral perfusion.
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