Samaniego Edgar A, Roa Jorge A, Limaye Kaustubh, Adams Harold P
Division of Cerebrovascular Diseases Department of Neurology, Neurosurgery and Radiology, Carver College of Medicine, UIHC Comprehensive Stroke Center, University of Iowa, Iowa City, Iowa.
School of Medicine, Universidad San Francisco de Quito, Quito, Ecuador.
J Stroke Cerebrovasc Dis. 2018 Oct;27(10):2555-2571. doi: 10.1016/j.jstrokecerebrovasdis.2018.05.025. Epub 2018 Jun 28.
The treatment of acute ischemic stroke due to large vessel occlusion (LVO) has revolutionized in the last decade. We sought to compile the most relevant literature published about the evolution in treating this disabling and fatal disease.
A literature review of recent studies describing early treatment options like intravenous tissue plasminogen activator to the latest mechanical thrombectomy (MT) techniques was performed. We described in a chronological order the evolution of LVO treatment.
Recanalization rates with newer techniques and MT devices approach a 90% of effectiveness. Timely interventions have also resulted in better clinical outcomes with approximately 50% of patient achieving functional independence at 90 days. At least 14 new third generation thrombectomy devices are currently being evaluated in in vitro and clinical studies.
The treatment of LVO with MT is feasible and safe. MT is standard of care in treating acute ischemic stroke due to LVO.
在过去十年中，因大血管闭塞（LVO）导致的急性缺血性卒中的治疗发生了变革。我们试图汇编已发表的有关治疗这种致残性和致命性疾病进展的最相关文献。
对近期研究进行文献综述，这些研究描述了从静脉注射组织纤溶酶原激活剂等早期治疗方案到最新的机械取栓术（MT）技术。我们按时间顺序描述了LVO治疗的进展。
采用更新技术和MT设备的再通率接近90%的有效性。及时干预也带来了更好的临床结果，约50%的患者在90天时实现功能独立。目前至少有14种新型第三代取栓设备正在进行体外和临床研究评估。
采用MT治疗LVO是可行且安全的。MT是治疗因LVO导致的急性缺血性卒中的标准治疗方法。
