Department of Radiology and Neurological Surgery, Columbia University, College of Physicians & Surgeons, The Neurological Institute, 710 West 168th Street, Suite 428, New York, New York 10032, USA.
J Neurosurg. 2010 Jul;113(1):149-52. doi: 10.3171/2009.12.jns091813.
Stroke is the third leading cause of death in the USA, Canada, Europe, and Japan. According to the American Heart Association and the American Stroke Association, there are now 750,000 new strokes that occur each year, resulting in 200,000 deaths, or 1 of every 16 deaths, per year in the USA alone. Endovascular therapy for patients with acute ischemic stroke is an area of intense investigation. The American Stroke Association has given a qualified endorsement of intraarterial thrombolysis in selected patients. Intraarterial thrombolysis has been studied in two randomized trials and numerous case series. Although two devices have been granted FDA approval with an indication for mechanical stroke thrombectomy, none of these thrombectomy devices has demonstrated efficacy for the improvement of patient outcomes. The purpose of the present document is to define what constitutes adequate training to perform neuroendovascular procedures in patients with acute ischemic stroke and what performance standards should be adopted to assess outcomes. These guidelines have been written and approved by multiple neuroscience societies which historically have been directly involved in the medical, surgical and endovascular care of patients with acute stroke. The participating member organizations of the Neurovascular Coalition involved in the writing and endorsement of this document are the Society of NeuroInterventional Surgery, the American Academy of Neurology, the American Association of Neurological Surgeons/Congress of Neurological Surgeons Cerebrovascular Section, and the Society of Vascular & Interventional Neurology.
中风是美国、加拿大、欧洲和日本的第三大致死原因。根据美国心脏协会和美国中风协会的数据，目前每年有 75 万例新的中风病例发生，导致 20 万人死亡，仅在美国，每年每 16 例死亡中就有 1 例是中风导致的。急性缺血性中风患者的血管内治疗是一个研究热点。美国中风协会已经对选择性患者的动脉内溶栓给予了有条件的认可。动脉内溶栓已在两项随机试验和多项病例系列研究中进行了研究。尽管有两种设备已获得 FDA 批准用于机械性卒中血栓切除术的适应症，但这些血栓切除术设备都没有证明对改善患者预后有效。本文件的目的是定义在急性缺血性中风患者中进行神经血管内手术所需的适当培训内容，以及应采用哪些绩效标准来评估结果。这些指南由多个神经科学学会撰写和批准，这些学会历史上一直直接参与急性中风患者的医疗、手术和血管内治疗。参与本文件撰写和认可的神经血管联盟的成员组织包括神经介入外科学会、美国神经病学学会、美国神经外科学会/神经外科学会脑血管分会以及血管与介入神经病学学会。
