Interventional Neuroradiology Department, Fondation Rothschild Hospital , Paris, France.
Université Paris Denis Diderot, Sorbonne Paris Cite , Paris, France.
Expert Rev Med Devices. 2020 Jul;17(7):697-706. doi: 10.1080/17434440.2020.1784004. Epub 2020 Jun 25.
Acute ischemic stroke (AIS) secondary to the occlusion of a large intracranial vessel (LVO) is a recognized public health problem. Mechanical thrombectomy (MT) has gained full acceptance: Class A, Level 1 in 2015 after the publication of numerous trials. Further meta-analyses have scrutinized extensively those results and international recommendations and guidelines have been given. Nevertheless, multiple-specific points remain to be clarified and are or will be under investigations.
This review of the most recent literature (mostly publications after 2015) will cover the actual common practice for MT, especially focusing on the devices available (and their validation), how they are commonly used, relate the most relevant results, and detail some emerging technologies.
The authors will express their own view on the current practice and emphasize on the areas where questions remain and hypothesize what specific improvements are necessary and prone to occur.
由颅内大血管闭塞引起的急性缺血性脑卒中(AIS)是一个公认的公共卫生问题。机械取栓(MT)在 2015 年大量试验发表后得到了充分认可:A 级,1 级。进一步的荟萃分析广泛审查了这些结果,国际建议和指南也已给出。然而,仍有多个具体问题需要澄清,目前正在或将要进行调查。
本综述对最新文献(主要是 2015 年后的出版物)进行了回顾,涵盖了 MT 的实际常见做法,特别是侧重于现有设备(及其验证)、其常用方法、相关的最重要结果,并详细介绍了一些新兴技术。
作者将对当前的实践发表自己的看法,并强调仍存在问题的领域,并假设哪些具体的改进是必要的和可能的。