Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, USA.
Departments of Emergency Medicine and Neurology, Medical University of South Carolina, Charleston, South Carolina, USA.
J Neurointerv Surg. 2018 Nov;10(11):1047-1052. doi: 10.1136/neurintsurg-2018-013951. Epub 2018 Jul 12.
Endovascular thrombectomy (EVT) is now the standard of care for eligible patients with acute ischemic stroke (AIS) secondary to emergent large vessel occlusion (ELVO). However, there remains uncertainty in how hospital systems can most efficiently route patients with suspected ELVO for EVT treatment. Given the relative geographic distribution of centers with and without endovascular capabilities, the value of prehospital triage directly to centers with the ability to provide EVT remains debated. While there are no randomized trial data available to date, there is substantial evidence in the literature that may offer guidance on the subject. In this review we examine the available data in the context of improving the existing AIS triage systems and discuss how prehospital triage directly to endovascular-capable centers may confer clinical benefits for patients with suspected ELVO.
血管内血栓切除术（EVT）现在是符合条件的急性缺血性卒中（AIS）继发于紧急大血管闭塞（ELVO）患者的标准治疗方法。然而，在如何使疑似 ELVO 的患者以最高效率送往 EVT 治疗中心方面仍然存在不确定性。鉴于具有和不具有血管内能力的中心的相对地理分布，将患者直接分诊到具有 EVT 能力的中心的价值仍然存在争议。虽然目前尚无随机试验数据，但文献中有大量证据可能为此提供指导。在这篇综述中，我们在完善现有的 AIS 分诊系统的背景下研究了现有数据，并讨论了将疑似 ELVO 的患者直接分诊到血管内治疗中心可能为患者带来的临床益处。
