Hayakawa Mikito
Division of Stroke Prevention and Treatment, Faculty of Medicine, University of Tsukuba.
Rinsho Shinkeigaku. 2019 Feb 23;59(2):77-83. doi: 10.5692/clinicalneurol.cn-001244. Epub 2019 Jan 31.
From 2014 to 2015, the five pivotal stroke trials (MR CLEAN, ESCAPE, EXTEND-IA, SWIFT PRIME and REVASCAT) have shown that stroke thrombectomy clearly improved functional outcome of patients with occlusion of the internal carotid artery or the M1 portion of the middle cerebral artery, with a baseline National Institutes of Health Stroke Scale score of ≥6, with a baseline Alberta Stroke Program Early Computed Tomography Score of ≥6, and who could receive thrombectomy within a 6-hour window of symptom onset. In 2018, the efficacy of stroke thrombectomy for patients with late-presenting stroke up to 16 to 24 hours of onset and who had clinical imaging mismatch or target mismatch was also established by the DAWN and the DEFUSE3 trials. Nowadays, stroke thrombectomy, therefore, have become a "standard of care" and acute stroke patients with large vessel occlusion should receive stroke thrombectomy if they meet top-tier evidence criteria.
2014年至2015年期间，五项关键的中风试验（MR CLEAN、ESCAPE、EXTEND-IA、SWIFT PRIME和REVASCAT）表明，对于颈内动脉或大脑中动脉M1段闭塞、美国国立卫生研究院卒中量表基线评分≥6、阿尔伯塔卒中项目早期计算机断层扫描评分≥6且能在症状发作6小时内接受血栓切除术的患者，中风血栓切除术明显改善了其功能预后。2018年，DAWN和DEFUSE3试验也证实了中风血栓切除术对发病16至24小时且存在临床影像不匹配或目标不匹配的延迟就诊中风患者的疗效。因此，如今中风血栓切除术已成为“标准治疗方法”，符合顶级证据标准的急性大血管闭塞中风患者应接受中风血栓切除术。
