Departments of Medical Imaging & Neurosurgery, University of Toronto, Toronto, Ontario, Canada.
Departments of Medical Imaging & Neurosurgery, University of Toronto, Toronto, Ontario, Canada.
Eur J Radiol. 2019 Mar;112:214-221. doi: 10.1016/j.ejrad.2019.01.029. Epub 2019 Jan 29.
After being staggered by numerous negative trials in 2013, the interventional stroke community saw four years of vindication for mechanical thrombectomy showing efficacy and safety, even beyond a hopeful 6-8 hour window out to 24 h. A landmark set of five trials in 2015 provided a foundation upon which years of incremental follow-ups, meta-analyses and new breakthroughs would be built. With optimized devices for thrombectomy and image analysis, the neurointerventional community has turned to workflow and systemization in this new era of acute ischemic stroke treatment. The aim of this review is to chronicle the evidence in the epoch of positive trials, synthesize ancillary studies to these, and discuss the imminent challenges that remain.
2013 年多项负面试验令人震惊之后，介入卒中领域迎来了机械取栓术的四年验证期，其疗效和安全性得到证实，甚至在充满希望的 6-8 小时窗口之外，延长至 24 小时。2015 年具有里程碑意义的五项试验为之后数年的增量随访、荟萃分析和新突破奠定了基础。随着取栓和图像分析设备的优化，神经介入领域在急性缺血性脑卒中治疗的新时代转向了工作流程和系统化。本文旨在记录阳性试验时代的证据，综合这些辅助研究，并讨论仍然存在的迫切挑战。
