Yamagami Hiroshi
Department of Stroke Neurology, National Hospital Organization Osaka National Hospital.
No Shinkei Geka. 2023 Mar;51(2):337-346. doi: 10.11477/mf.1436204749.
The efficacy and safety of endovascular thrombectomy for acute ischemic stroke due to large vessel occlusion have been established, and a shorter time from onset to reperfusion has a strong impact on the outcome. Therefore, improving the stroke system of care, including ambulance transportation, is important. Trials on efficient transport have been conducted using the pre-hospital stroke scale, comparison of mothership and drip and ship systems, and workflow after arrival to stroke centers. The Japan Stroke Society has started to certify primary stroke centers and core primary stroke centers(thrombectomy-capable stroke centers). We review the literature on stroke systems of care and discuss policies that academic societies and policies are aiming for in Japan.
血管内血栓切除术治疗大血管闭塞所致急性缺血性卒中的疗效和安全性已得到证实，从发病到再灌注的时间越短对预后的影响越大。因此，改善包括救护车转运在内的卒中医疗体系很重要。已开展了多项关于高效转运的试验，包括使用院前卒中量表、母船与点滴与转运系统的比较以及抵达卒中中心后的工作流程。日本卒中协会已开始认证初级卒中中心和核心初级卒中中心（具备血栓切除术能力的卒中中心）。我们回顾了关于卒中医疗体系的文献，并讨论了学术团体和政策在日本所追求的目标。
