医学
纸牌密码算法
半影
随机对照试验
冲程(发动机)
血运重建
随机化
临床试验
外科
缺血性中风
内科学
心肌梗塞
缺血
改良兰金量表
机械工程
工程类
作者
Joseph C. Serrone,Lincoln Jimenez,Andrew J. Ringer
出处
期刊:Neurosurgery
[Oxford University Press]
日期:2014-02-01
卷期号:74 (Supplement 1): S133-S141
被引量:12
标识
DOI:10.1227/neu.0000000000000224
摘要
Of the approximately 795,000 strokes in the United States annually, 87% are ischemic and result in significant morbidity and mortality. Improvements in acute ischemic stroke (AIS) outcomes have been achieved with intravenous thrombolytics (IVT) and intra-arterial thrombolytics vs supportive medical therapy. Given its ease of administration, noninvasiveness, and most validated efficacy, IVT is the standard of care in AIS patients without contraindications to systemic fibrinolysis. However, patients with large-vessel occlusions respond poorly to IVT. Recent trials designed to select this population for randomization to IVT vs IVT with adjunctive endovascular therapy have not shown improvement in clinical outcomes with endovascular therapy. This could be due to the lack of utilization of modern thrombectomy devices such as Penumbra aspiration devices, Solitaire stent-trievers, or Trevo stent-trievers, which have shown the best recanalization results. Continued improvement in the techniques with using these devices as well as randomized controlled trials using them is warranted. This article defines the goals of AIS revascularization, presents the evolution of treatment from the initial use of IVT to modern thrombectomy devices, and discusses current treatment and ongoing AIS trials.
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