Loughborough W, Mahady K, Bradley M D, Renowden S A, Mortimer A M
Department of Radiology (Neuroradiology Section), Southmead Hospital, North Bristol NHS Trust, Bristol, UK.
Department of Radiology (Neuroradiology Section), Southmead Hospital, North Bristol NHS Trust, Bristol, UK.
Clin Radiol. 2016 Jan;71(1):2-8. doi: 10.1016/j.crad.2015.09.012. Epub 2015 Nov 6.
Recent trial evidence suggests that for patients suffering large-vessel occlusive stroke, endovascular therapy based on the stent-retriever technique is associated with superior clinical outcomes when compared to intravenous thrombolysis alone. The challenge now is how this service is to be delivered. This may involve both centralisation of services around large cities and development of robust networks to receive patients from district general hospitals situated further afield. Both diagnostic and interventional neuroradiology will need to expand. Furthermore, we suggest that it would be advantageous for radiology departments in those hospitals receiving hyperacute stroke patients to perform computed tomography (CT) angiography in addition to non-contrast CT, which also has implications for service delivery in these units. This could swiftly aid identification of patients who might benefit from thrombectomy and improve decision-making through demonstration of occlusive thrombus and of collateral status.
近期的试验证据表明，对于患有大血管闭塞性中风的患者，与单纯静脉溶栓相比，基于支架取栓技术的血管内治疗具有更好的临床效果。目前的挑战在于如何提供这项服务。这可能既包括围绕大城市集中服务，也包括建立强大的网络以接收来自更远地区综合医院的患者。诊断性和介入性神经放射学都需要扩展。此外，我们认为，对于接收超急性中风患者的医院的放射科来说，除了进行非增强CT外，还进行CT血管造影将是有益的，这也对这些科室的服务提供有影响。这可以迅速帮助识别可能从血栓切除术获益的患者，并通过显示闭塞性血栓和侧支循环状态来改善决策。
