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亚洲人群急性缺血性卒中血管内有效治疗的影响因素

Factors Contributing to an Efficacious Endovascular Treatment for Acute Ischemic Stroke in Asian Population.

作者信息

Lee Jin Soo, Hwang Yang-Ha, Sohn Sung-Il

机构信息

Department of Neurology, Ajou University Hospital, Ajou University School of Medicine, Suwon, Korea.

Department of Neurology, Kyungpook National University Hospital, School of Medicine, Kyungpook National University, Daegu, Korea.

出版信息

Neurointervention. 2021 Jul;16(2):91-110. doi: 10.5469/neuroint.2020.00339. Epub 2021 Mar 26.

Abstract

Although randomized control trials about endovascular treatment (EVT) of emergent large vessel occlusion (LVO) have demonstrated the success of mechanical thrombectomy as the choice of treatment, a wide range of caveats remain unaddressed. Asian patients were rarely included in the trials, thereby raising the question of whether the treatment could be generalized. In addition, there remains a concern on the feasibility of the method with respect to its application against intracranial atherosclerosis (ICAS)-related LVO, frequently observed in the Asian population. It is important to include evidence on ICAS LVO from Asian countries in the future for a comprehensive understanding of LVO etiology. Besides the issues with EVT, prognostic concerns in diabetes patients, acute kidney injury following EVT, neuroprotective management against reperfusion injury, and other peri-EVT issues should be considered in clinical practice. In the current article, we present an in-depth review of the literature that revises information pertaining to such concerns.

摘要

尽管关于急诊大血管闭塞(LVO)血管内治疗(EVT)的随机对照试验已证明机械取栓术作为治疗选择是成功的,但仍有诸多问题未得到解决。这些试验很少纳入亚洲患者,因此引发了该治疗方法能否推广的问题。此外,对于该方法应用于亚洲人群中常见的颅内动脉粥样硬化(ICAS)相关LVO的可行性仍存在担忧。未来纳入来自亚洲国家关于ICAS LVO的证据对于全面了解LVO病因很重要。除了EVT的问题外,临床实践中还应考虑糖尿病患者的预后问题、EVT后的急性肾损伤、针对再灌注损伤的神经保护管理以及其他围EVT问题。在本文中,我们对相关文献进行了深入综述,以修正有关这些问题的信息。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fc1e/8261106/1ceaef3df67f/neuroint-2020-00339f1.jpg

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