急性缺血性卒中的血管内管理与治疗
Endovascular management and treatment of acute ischemic stroke.
作者信息
Mokin Maxim, Snyder Kenneth V, Siddiqui Adnan H, Hopkins L Nelson, Levy Elad I
机构信息
Department of Neurosurgery, School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA; Department of Neurosurgery, Gates Vascular Institute, Kaleida Health, Buffalo, NY, USA.
Department of Neurosurgery, School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA; Department of Neurosurgery, Gates Vascular Institute, Kaleida Health, Buffalo, NY, USA; Department of Neurology, School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA; Department of Radiology, School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA; Toshiba Stroke and Vascular Research Center, School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA.
出版信息
Neurosurg Clin N Am. 2014 Jul;25(3):583-92. doi: 10.1016/j.nec.2014.04.013. Epub 2014 May 20.
Endovascular intra-arterial therapy is reserved for strokes from large vessel occlusion. This article reviews the critical role of the location of the occlusion, extent and characteristics of the occlusive thrombus on noninvasive imaging, and identification of ischemic core and salvageable tissue on perfusion imaging for proper patient selection. The advantages of stentrievers over other mechanical thrombectomy approaches are discussed and the role of the aspiration thrombectomy approach in modern clinical practice is reviewed. Finally, the implications of the results of recent randomized trials of endovascular therapy on the future of intra-arterial revascularization therapies are discussed.
血管内动脉内治疗适用于大血管闭塞性卒中。本文回顾了闭塞部位的关键作用、无创成像上闭塞血栓的范围和特征，以及灌注成像上缺血核心和可挽救组织的识别，以进行恰当的患者选择。讨论了支架取栓器相对于其他机械取栓方法的优势，并回顾了抽吸取栓方法在现代临床实践中的作用。最后，讨论了近期血管内治疗随机试验结果对动脉内血管再通治疗未来的影响。
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