ACUTE ISCHEMIC STROKE: ENDOVASCULAR REPERFUSION AND EARLY REHABILITATION - A PERSONALIZED IMAGING-GUIDED APPROACH

Main Article Content

Kilichev Farruh Ahmadovich
Yarmuhamedova Nargiza Anvarovna
Aliyev Mansur

Abstract

Acute ischemic stroke remains one of the leading causes of mortality and long- term disability worldwide. While intravenous thrombolysis with tissue plasminogen activator has significantly improved early stroke management, its effectiveness is limited by a narrow therapeutic window and incomplete recanalization in large vessel occlusions. Recent advances in endovascular reperfusion techniques have transformed the treatment landscape, offering higher rates of successful vessel recanalization and improved clinical outcomes. Modern approaches including mechanical thrombectomy, aspiration thrombectomy, and intra-arterial thrombolysis have demonstrated superior efficacy, particularly when combined with intravenous thrombolytic therapy. In addition, the development of novel fibrinolytic agents and adjunctive methods such as ultrasound-enhanced thrombolysis has further expanded therapeutic possibilities. Alongside reperfusion strategies, early initiation of rehabilitation plays a critical role in enhancing neurological recovery, promoting neuroplasticity, and reducing long-term disability. The integration of advanced endovascular interventions with early rehabilitation represents a comprehensive and patient-centered approach to the management of acute ischemic stroke. Future perspectives emphasize individualized, imaging-guided treatment strategies and multidisciplinary care to optimize functional outcomes and extend therapeutic time windows.

Article Details

How to Cite
Ahmadovich, K. F., Anvarovna, Y. N., & Mansur, A. (2026). ACUTE ISCHEMIC STROKE: ENDOVASCULAR REPERFUSION AND EARLY REHABILITATION - A PERSONALIZED IMAGING-GUIDED APPROACH. Research Focus International Scientific Journal, 5(4), 193–200. Retrieved from https://refocus.uz/index.php/rf/article/view/2324
Section
14.00.00 – Medical sciences

References

Bernhardt, J., Godecke, E., Johnson, L., & Langhorne, P. (2016). Early rehabilitation after stroke. Current Opinion in Neurology, 30, 48–

https://doi.org/10.1097/wco.0000000000000404

Bhaskar, S., Stanwell, P., Cordato, D., Attia, J., & Levi, C. (2018). Reperfusion therapy in acute ischemic stroke: dawn of a new era?. BMC Neurology

https://doi.org/10.1186/s12883-017- 1007-y

Campbell, B., Mitchell, P., Kleinig, T., Dewey, H., Churilov, L., Yassi, N., Yan, B., Dowling, R. Parsons, M., Oxley, T., Wu, T., Brooks, M., Simpson, M., Miteff, F., Levi, C., Krause, M. Harrington, T., Faulder, K., Steinfort, B., Priglinger, M., Ang, T., Scroop, R., Barber, P. McGuinness, B., Wijeratne, T., Phan, T., Chong, W., Chandra, R., Bladin, C., Badve, M., Rice, H. De Villiers, L., , H., Desmond, P., Donnan, G., & Davis, S. (2015). Endovascular therapy for ischemic stroke with perfusion-imaging selection.. The New England journal of medicine, 372 11 1009-

https://doi.org/10.1056/nejmoa1414792

Coleman, E., Moudgal, R., Lang, K., Hyacinth, H., Awosika, O., Kissela, B., & Feng, W. (2017). Early Rehabilitation After Stroke: a Narrative Review. Current Atherosclerosis Reports, 19, 1-

https://doi.org/10.1007/s11883-017-0686-6

Galimov, A., Stenkina, N., Gaikina, E., Shafikova, E., Bashirova, A., Yapparov, A., Amirkhanyan A., Rozhkov, M., Morozov, N., Davletbaeva, N., Gimranova, N., Yamgurova, R. Shagiakhmetova, D., Sultanmuratov, I., & Reshetnikova, A. (2025). Modern approaches to the management of early rehabilitation period after ischemic stroke. Medical and Social Expert Evaluation and Rehabilitation. https://doi.org/10.17816/mser680937

Hasan, T., Hasan, H., & Kelley, R. (2021). Overview of Acute Ischemic Stroke Evaluation and Management. Biomedicines

https://doi.org/10.3390/biomedicines9101486

He, Y., Nie, X., He, T., Qi, X., Chen, Z., Duan, W., Wei, Y., Liu, X., & Liu, Y. (2022). Impact of Early Rehabilitation on Outcomes in Patients With Acute Ischemic Stroke After Endovascular Treatment. Frontiers in Neurology

https://doi.org/10.3389/fneur.2022.877773

Lou, Y., Liu, Z., Ji, Y., Cheng, J., Zhao, C., & Li, L. (2024). Efficacy and safety of very early rehabilitation for acute ischemic stroke: a systematic review and meta-analysis. Frontiers in Neurology

https://doi.org/10.3389/fneur.2024.1423517

Mohammaden, M., Haussen, D., & Nogueira, R. (2021). Therapeutic Advancements in the Endovascular Management of Acute Ischemic Stroke. Stroke: Vascular and Interventional Neurology. https://doi.org/10.1161/svin.121.000168

Molina, C., & Saver, J. (2005). Extending Reperfusion Therapy for Acute Ischemic Stroke: Emerging Pharmacological, Mechanical, and Imaging Strategies. Stroke, 36, 2311-2320. https://doi.org/10.1161/01.str.0000182100.65262.46

Mouyal, S., Diaz, H., Zuber, M., Tamazyan, R., Romulus, A., Désilles, J., Olivot, J., Mazighi, M. & Maïer, B. (2025). Endovascular therapy for acute ischemic stroke: From a decade of trials to the next frontier.. Med, 100889. https://doi.org/10.1016/j.medj.2025.100889

Nguyen, T., Abdalkader, M., Fischer, U., Qiu, Z., Nagel, S., Chen, H., Miao, Z., & Khatri, P. (2024). Endovascular management of acute stroke. The Lancet, 404, 1265-1278. https://doi.org/10.1016/s0140-6736(24)01410-7

Tong, Y., Ding, Y., Han, Z., Duan, H., & Geng, X. (2023). Optimal rehabilitation strategies for early postacute stroke recovery: An ongoing inquiry. Brain Circulation, 9, 201 - 204. https://doi.org/10.4103/bc.bc_33_23

Wang, F., Zhang, S., Zhou, F., Zhao, M., & Zhao, H. (2021). Early physical rehabilitation therapy between 24 and 48 h following acute ischemic stroke onset: a randomized controlled trial. Disability and Rehabilitation, 44, 3967 - 3972. https://doi.org/10.1080/09638288.2021.1897168

Wang, Q., Liu, N., Simo, L., , Q., & Li, C. (2025). A narrative review of reperfusion therapy in acute ischemic stroke: Emerging advances, current challenges, and future directions. Brain Circulation, 11, 187 - 199. https://doi.org/10.4103/bc.bc_161_24

Wei, X., Sun, S., Zhang, M., & Zhao, Z. (2024). A systematic review and meta-analysis of clinical efficacy of early and late rehabilitation interventions for ischemic stroke. BMC Neurology

https://doi.org/10.1186/s12883-024-03565-8

Widimsky, P., Snyder, K., Sulženko, J., Hopkins, L., & Štětkářová, I. (2022). Acute ischaemic stroke: recent advances in reperfusion treatment. European Heart Journal, 44, 1205 - 1215. https://doi.org/10.1093/eurheartj/ehac684

Wu, W., Zhou, C., Wang, Z., Chen, G., Chen, X., Jin, H., & He, D. (2020). Effect of Early and Intensive Rehabilitation after Ischemic Stroke on Functional Recovery of the Lower Limbs: A Pilot, Randomized Trial.. Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association, 104649. https://doi.org/10.1016/j.jstrokecerebrovasdis.2020.104649

Xiong, Y., Wakhloo, A., & Fisher, M. (2022). Advances in Acute Ischemic Stroke Therapy.. Circulation research, 130 8, 1230-1251. https://doi.org/10.1161/circresaha.121.319948