Bae Jin Woo, Hyun Dong Keun
Department of Neurosurgery, Inha University Hospital, Incheon, Korea.
Incheon Regional Cardio-cerebrovascular Disease Center, Incheon, Korea.
J Korean Neurosurg Soc. 2024 Jul;67(4):397-410. doi: 10.3340/jkns.2023.0181. Epub 2024 Mar 29.
Endovascular thrombectomy (EVT) has been established as the standard of care in the treatment of acute ischemic stroke (AIS) based on landmark randomized controlled trials. Nevertheless, while the strict eligibility of EVT for AIS patients restrict the wide application of EVT, a considerable population still undergoes off-label EVT. Besides, it is important to acknowledge that recanalization is not achieved in approximately 20% of procedures, and more than 50% of patients who undergo EVT still do not experience a favorable outcome. This article reviews the brief history of EVT trials and recent progressions in the treatment of AIS, with focusing on the expanding eligibility criteria, new target for EVT, and the evolution of EVT techniques.
基于具有里程碑意义的随机对照试验,血管内血栓切除术(EVT)已成为治疗急性缺血性卒中(AIS)的标准治疗方法。然而,尽管EVT对AIS患者的严格入选标准限制了其广泛应用,但仍有相当一部分患者接受了超适应证的EVT治疗。此外,必须认识到,约20%的手术未能实现再通,超过50%接受EVT治疗的患者仍未获得良好预后。本文回顾了EVT试验的简史以及AIS治疗的最新进展,重点关注不断扩大的入选标准、EVT的新靶点以及EVT技术的演变。