Department of Neurosurgery, Hadassah-Hebrew University Medical Center, POB 12000, Jerusalem 91120, Israel.
Neurol Clin. 2013 Aug;31(3):705-19. doi: 10.1016/j.ncl.2013.03.009. Epub 2013 Apr 15.
Although intravenous thrombolysis with recombinant tissue plasminogen activator is a proven effective therapy for acute ischemic stroke, it is often insufficient to achieve recanalization in patients with large intracranial artery occlusions. In these cases, intra-arterial reperfusion techniques may be useful. Intra-arterial thrombolysis has been largely replaced by mechanical thrombectomy as the preferred endovascular approach. Rapid technological advances have led to the development and refinement of various neurothrombectomy devices. This article reviews the evolution of neuroendovascular approaches for the management of severe acute ischemic stroke, including evidence from the main trials evaluating clinical and angiographic outcomes after neurothrombectomy.
尽管重组组织型纤溶酶原激活物静脉溶栓是治疗急性缺血性脑卒中的有效方法，但对于颅内大血管闭塞的患者，往往难以实现再通。在这些情况下，动脉内再灌注技术可能有用。动脉内溶栓已被机械取栓术在很大程度上取代，成为首选的血管内治疗方法。快速的技术进步导致了各种神经血栓切除术器械的发展和改进。本文综述了神经血管内治疗严重急性缺血性脑卒中的方法的演变，包括评估神经血栓切除术后临床和血管造影结果的主要试验的证据。
