Bhogal Pervinder, Andersson Tommy, Maus Volker, Mpotsaris Anastasios, Yeo Leonard
St. Bartholomew's and the Royal London Hospital, Whitechapel Road, E1 1BB, London, UK.
Departments of Neuroradiology and Clinical Neuroscience, Karolinska University Hospital and Karolinska Institutet, Stockholm, Sweden.
Clin Neuroradiol. 2018 Sep;28(3):313-326. doi: 10.1007/s00062-018-0692-2. Epub 2018 May 9.
The recent success of endovascular stroke treatment has heralded a new era in the management of acute ischemic stroke (AIS) with significantly improved outcome for patients. A large number of patients may be amenable to this new treatment and as the evidence expands the number of patients eligible for mechanical thrombectomy continues to increase. Recent evidence suggests that the time window for treatment can be extended up to 24 h after symptom onset for patients with anterior circulation strokes; however, many clinicians and medical professionals may not be aware of these recent changes and it is important that they are kept up-to-date with this rapidly evolving treatment. This review provides an overview of the recent successful trials and highlights important steps that should be instituted in order to achieve rapid reperfusion and optimize the outcome for ischemic stroke patients. It also looks at the remaining controversies facing the field of thrombectomy. A short summary of each of these contentious areas is provided and the current state of the art.
血管内卒中治疗的近期成功开创了急性缺血性卒中(AIS)管理的新纪元,显著改善了患者的预后。大量患者可能适合这种新治疗方法,并且随着证据的不断扩展, eligible for mechanical thrombectomy的患者数量持续增加。最近的证据表明,对于前循环卒中患者,治疗时间窗可延长至症状发作后24小时;然而,许多临床医生和医学专业人员可能并未意识到这些最新变化,让他们了解这种快速发展的治疗方法的最新情况非常重要。本综述概述了近期成功的试验,并强调了为实现快速再灌注和优化缺血性卒中患者预后应采取的重要步骤。它还探讨了血栓切除术领域仍存在的争议。提供了这些有争议领域中每个领域的简短总结以及当前的技术水平。