Jadhav Ashutosh P, Jovin Tudor G
University of Pittsburgh Medical Center, UPMC Stroke Institute, Pittsburgh, PA, USA.
Brain Circ. 2016 Oct-Dec;2(4):178-182. doi: 10.4103/2394-8108.195283. Epub 2016 Dec 6.
Acute ischemic stroke continues to be a major cause of permanent disability and death worldwide. Outcomes are particularly poor in patients presenting with large vessel occlusive disease with resultant ischemia and tissue injury in large and eloquent territories. Intravenous thrombolysis has been the mainstay of medical therapy, however treatment is limited to a subset of patients and many patients continue to have poor outcomes. Three trials in 2013 investigating the benefit of intra-arterial therapy failed to demonstrate benefit over medical therapy alone. More recently, five trials in 2015 were completed demonstrating superior outcomes with intra-arterial therapy with improved results attributed to higher and faster rates of recanalization in a select patient population. These trials have introduced a new standard of care in the management of acute ischemic stroke patients.
急性缺血性中风仍然是全球永久性残疾和死亡的主要原因。对于患有大血管闭塞性疾病并在大面积功能区导致缺血和组织损伤的患者，其预后尤其不佳。静脉溶栓一直是药物治疗的主要手段，然而治疗仅限于一部分患者，许多患者的预后仍然很差。2013年的三项研究动脉内治疗益处的试验未能证明其优于单纯药物治疗。最近在2015年完成的五项试验表明，动脉内治疗的结果更优，在特定患者群体中再通率更高、更快，从而带来了更好的治疗效果。这些试验为急性缺血性中风患者的管理引入了新的护理标准。
