Department of Neurology, University Clinic of Odessa National Medical University, Odessa, Ukraine.
TeleHealth Consulting Service, Medical Center "Expert Health," Odessa, Ukraine.
Semin Neurol. 2023 Jun;43(3):397-407. doi: 10.1055/s-0043-1771454. Epub 2023 Aug 7.
The last decade's progress in demonstrating the clinical benefit of endovascular thrombectomy (EVT) in patients with large vessel occlusion stroke has transformed the paradigm of care for these patients. This review presents the milestones in implementing EVT as standard of care, demonstrates the current state of evidence, provides guidance for identifying the candidate patient for EVT, and highlights unsolved and controversial issues. Ongoing trials investigate broadening of EVT indications for patients who present with large core infarction, adjunctive intra-arterial thrombolysis, medium vessel occlusion, low NIHSS, and tandem occlusion.
过去十年的研究进展表明，血管内血栓切除术（EVT）在大血管闭塞性脑卒中患者中的临床获益，改变了此类患者的治疗模式。本文介绍了将 EVT 作为标准治疗方案的重要进展，阐述了目前的研究证据，为识别 EVT 候选患者提供了指导，并强调了尚未解决和存在争议的问题。目前正在进行的试验研究扩大了 EVT 的适应证，包括大梗死核心、动脉内溶栓辅助治疗、中等大小血管闭塞、NIHSS 评分较低以及串联性闭塞等患者。
