Acute Ischemic Stroke Intervention

被引：148

作者：

Khandelwal, Priyank ^{[1
]}

Yavagal, Dileep R. ^{[2
,3
]}

Sacco, Ralph L. ^{[2
]}

机构：

[1] Brigham & Womens Hosp, Dept Intervent Neuroradiol, 75 Francis St, Boston, MA 02115 USA

[2] Univ Miami, Miller Sch Med, Dept Neurol, 1140 Northwest 14th St, Miami, FL 33136 USA

[3] Univ Miami, Miller Sch Med, Dept Neurosurg, Miami, FL 33136 USA

来源：

JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY | 2016年 / 67卷 / 22期

关键词：

large vessel occlusion; mechanical thrombectomy; stent retrievers; stroke systems; TISSUE-PLASMINOGEN ACTIVATOR; HEALTH-CARE PROFESSIONALS; COMPUTED-TOMOGRAPHY SCORE; INTRAVENOUS T-PA; ENDOVASCULAR TREATMENT; EARLY MANAGEMENT; MECHANICAL THROMBECTOMY; CLINICAL-OUTCOMES; RANDOMIZED-TRIAL; ALBERTA STROKE;

D O I：

10.1016/j.jacc.2016.03.555

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Acute ischemic stroke (AIS) is the leading cause of disability worldwide and among the leading causes of mortality. Although intravenous tissue plasminogen activator (IV-rtPA) was approved nearly 2 decades ago for treatment of AIS, only a minority of patients receive it due to a narrow time window for administration and several contraindications to its use. Endovascular approaches to recanalization in AIS developed in the 1980s, and recently, 5 major randomized trials showed an overwhelming superior benefit of combining endovascular mechanical thrombectomy with IV-rtPA over IV-rtPA alone. In this paper, we discuss the evolution of catheter-based treatment from first-generation thrombectomy devices to the game-changing stent retrievers, results from recent trials, and the evolving stroke systems of care to provide timely access to acute stroke intervention to patients in the United States. (C) 2016 by the American College of Cardiology Foundation.

引用

页码：2631 / 2644

页数：14

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