Department of Neurology, University of California, San Francisco, 505 Parnassus Ave, Box 0114, San Francisco, CA, 94143-0114, USA.
Neurotherapeutics. 2019 Apr;16(2):360-368. doi: 10.1007/s13311-019-00724-5.
Ischemic stroke is a leading cause of death and disability throughout the world and is both preventable and treatable. This review focuses on the treatment of the most severe form of ischemic stroke, namely large-vessel ischemic stroke, using endovascular techniques. Such therapies were proven effective in 2015. These therapies are among the most beneficial surgical therapies ever subjected to randomized clinical trials. Recent research has explored treating patients up to 24 h following the onset of stroke using advanced imaging techniques to select patients with brain tissue still at risk. These new findings suggest there exists a tissue clock rather than a time clock when selecting patients for therapy. Stroke systems throughout the world are now embracing endovascular stroke therapy. Improving regional stroke systems of care and expanding eligibility for patients are a major focus of current research.
缺血性脑卒中是全世界范围内导致死亡和残疾的主要原因,具有可预防和可治疗的特点。本综述重点关注使用血管内技术治疗最严重的缺血性脑卒中,即大血管性缺血性脑卒中。此类疗法于 2015 年被证实有效。这些疗法是有史以来受益最大的经过随机临床试验的外科治疗方法之一。最近的研究探索了使用先进的影像学技术在卒中发病后 24 小时内对患者进行治疗,以选择仍有脑组织风险的患者。这些新发现表明,在选择患者进行治疗时,存在组织时钟而不是时间时钟。全世界的卒中系统现在都在接受血管内卒中治疗。改善区域卒中护理系统和扩大患者的资格是当前研究的主要重点。