Haußmann Alena
Klinik für Diagnostische und Interventionelle Neuroradiologie, Universitätsklinikum des Saarlandes, Kirrberger Str., 66424, Homburg, Deutschland.
Radiologie (Heidelb). 2025 Feb;65(2):115-117. doi: 10.1007/s00117-024-01397-8. Epub 2024 Dec 19.
Acute ischemic stroke remains one of the most common causes of death in Germany and affects around 16,000 people every year. With the begin of using of i.v. lysis therapy in the mid-1990s and endovascular thrombectomy (after publication of randomized studies) in 2015, these two procedures represent the two most important pillars in acute therapy. In the absence of neuroradiology centers with endovascular treatment options, there are two principles for triaging of stroke patients-the drip-and-ship or mothership model. The question repeatedly arises as to whether and exactly when bridging i.v. lysis therapy should be used.
The S2 guideline for the treatment of acute stroke offers an evidence-based treatment decision for treating physicians and has been extended until 2026, with the exception of a few updates, due to its proven effectiveness.
Every stroke patient should receive i.v. lysis therapy, taking into account the onset of neurological symptoms and possible contraindications, regardless of the planned triaging principle.
急性缺血性卒中仍是德国最常见的死亡原因之一，每年影响约16000人。自20世纪90年代中期开始使用静脉溶栓治疗以及2015年血管内血栓切除术（在随机研究发表后）出现以来，这两种治疗方法成为急性治疗中两个最重要的支柱。在没有具备血管内治疗选择的神经放射学中心的情况下，对卒中患者进行分诊有两个原则——“边滴注边转运”或“母舰”模式。关于是否以及确切何时应采用桥接静脉溶栓治疗的问题反复出现。
急性卒中治疗的S2指南为治疗医生提供了基于证据的治疗决策，并且由于其已证实的有效性，除了少数更新外，该指南已延长至2026年。
每一位卒中患者都应接受静脉溶栓治疗，同时考虑神经症状的发作情况和可能的禁忌症，而不论计划采用的分诊原则如何。
