Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada; Department of Radiology, University of Calgary, Calgary, Alberta, Canada.
Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.
J Am Coll Cardiol. 2020 Apr 21;75(15):1832-1843. doi: 10.1016/j.jacc.2019.10.034.
Acute ischemic stroke is a severe and life-threatening disease, particularly when caused by a large-vessel occlusion. The only available 2 treatment options are intravenous alteplase and endovascular therapy (mechanical clot removal), both of which are highly time-dependent. Thus, rapid patient transfer, diagnosis, and treatment are crucial, and time-consuming imaging methods and overly selective treatment selection criteria should be avoided. A combined endovascular therapy approach using stent-retrievers and aspiration is the most effective way to achieve fast first-pass complete reperfusion and should thus be used. To diagnose and treat patients as fast as possible, the organization of existing systems of care, and particularly pre-hospital transfer systems, have to be changed. Several different transport models are currently in use because the optimal patient transfer paradigm is highly dependent on local geography and hospital efficiency.
急性缺血性脑卒中是一种严重且危及生命的疾病，尤其是由大血管闭塞引起的脑卒中。目前仅有两种治疗选择，即静脉内使用阿替普酶和血管内治疗（机械血栓清除），这两种治疗都高度依赖时间。因此，快速的患者转移、诊断和治疗至关重要，应避免耗时的成像方法和过度选择性的治疗选择标准。使用支架取栓和抽吸的联合血管内治疗方法是实现快速首次通过完全再灌注的最有效方法，因此应予以采用。为了尽可能快地诊断和治疗患者，必须改变现有的护理系统组织，特别是院前转移系统。目前有几种不同的转运模式，因为最佳的患者转运模式高度依赖于当地的地理环境和医院的效率。
