Raha Oishik, Hall Charles, Malik Abid, D'Anna Lucio, Lobotesis Kyriakos, Kwan Joseph, Banerjee Soma
Imperial Stroke Centre, Imperial College Healthcare NHS Trust, London, UK.
Interventional Neuroradiology, Imperial College Healthcare NHS Trust, London, UK.
BMJ Med. 2023 Aug 9;2(1):e000407. doi: 10.1136/bmjmed-2022-000407. eCollection 2023.
Mechanical thrombectomy is a ground breaking treatment for acute ischaemic stroke caused by occlusion of a large vessel. Its efficacy over intravenous thrombolysis has been proven in multiple trials with a lower number needed to treat than percutaneous coronary intervention for acute myocardial infarction. However, access to this key treatment modality remains limited with a considerable postcode lottery across the UK and many parts of the world. The evidence base for mechanical thrombectomy dates back to 2015. Since then, there have been important advances in establishing and widening the criteria for treatment. This narrative review aims to summarise the current evidence base and latest advances for physicians and academics with an interest in recanalisation treatments for acute ischaemic stroke.
机械取栓术是治疗由大血管闭塞引起的急性缺血性卒中的一项突破性疗法。在多项试验中已证实其疗效优于静脉溶栓,且与急性心肌梗死的经皮冠状动脉介入治疗相比,所需治疗人数更少。然而,在英国及世界许多地区,这种关键治疗方式的可及性仍然有限,存在着显著的邮政编码抽奖现象(即医疗资源分配不均)。机械取栓术的证据基础可追溯到2015年。自那时起,在确立和拓宽治疗标准方面取得了重要进展。这篇叙述性综述旨在为对急性缺血性卒中再通治疗感兴趣的医生和学者总结当前的证据基础和最新进展。