切换至 "中华医学电子期刊资源库"

中华神经创伤外科电子杂志 ›› 2019, Vol. 05 ›› Issue (05) : 310 -314. doi: 10.3877/cma.j.issn.2095-9141.2019.05.013

所属专题: 经典病例 经典病例 文献

综述

急性缺血性卒中血管内治疗筛选病例的研究进展
梁星宇1, 徐如祥2,(), 梁春阳2   
  1. 1. 100700 北京市东直门中学
    2. 100700 北京,解放军总医院第七医学中心神经外科
  • 收稿日期:2019-05-18 出版日期:2019-10-15
  • 通信作者: 徐如祥
  • 基金资助:
    首都特色临床医学技术发展研究基金(Z090507017709006); 首都医学发展科研基金(2009-2050)

Recent advance in selecting patients about endovascular treatment of acute ischemic stroke

Xingyu Liang1, Ruxiang Xu2,(), Chunyang Liang2   

  1. 1. Dongzhimen Middle School, Beijing 100700, China
    2. Department of Neurosurgery, Seventh Medical Center of PLA General Hospital, Beijing 100700, China
  • Received:2019-05-18 Published:2019-10-15
  • Corresponding author: Ruxiang Xu
  • About author:
    Corresponding author: Xu Ruxiang, Email:
引用本文:

梁星宇, 徐如祥, 梁春阳. 急性缺血性卒中血管内治疗筛选病例的研究进展[J/OL]. 中华神经创伤外科电子杂志, 2019, 05(05): 310-314.

Xingyu Liang, Ruxiang Xu, Chunyang Liang. Recent advance in selecting patients about endovascular treatment of acute ischemic stroke[J/OL]. Chinese Journal of Neurotraumatic Surgery(Electronic Edition), 2019, 05(05): 310-314.

急性缺血性卒中发病率呈逐年上升趋势,并且具有很高的致残率和致死率。由于静脉阿替普酶溶栓治疗急性缺血性卒中的局限性,2015年以来5大临床前瞻随机双盲多中心临床研究证实新一代血管再通策略(主要是可回收支架)在大血管闭塞导致的急性缺血性卒中明显优于单独内科治疗,各国脑卒中指南也相应进行更新。本文围绕5大临床研究及欧洲、美国最新指南中关于筛选合适卒中患者进行机械取栓的研究进展综述如下。

The incidence of acute ischemic stroke rises year by year, and has a high disability rate and mortality rate. Due to limitations of intravenous alteplase in the treatment of acute ischemic stroke, five randomized trials have demonstrated the benefit of new-generation endovascular recanalization therapies (primarily stent retrievers) over medical therapy alone among patients with acute ischemic stroke since 2015, and the guidelines with acute ischemic stroke guidelines have updated in many countries. This review focuses on five major clinical studies and the latest guidelines in Europe and the United States on the selection of suitable stroke patients for mechanical thrombectomy. The following is a review of the research progress.

[1]
Emberson J,Lees KR,Lyden P, et al. Effect of treatment delay, age, and stroke severity on the effects of intravenous thrombolysis with alteplase for acute ischaemic stroke: a meta-analysis of individual patient data from randomised trials[J]. Lancet, 2014, 384: 1929-1935.
[2]
Jauch EC,Saver JL,Adams HP Jr, et al. Guidelines for the early management of patients with acute ischemic stroke: a guideline for healthcare professionals from the American Heart Association/American Stroke Association[J]. Stroke, 2013, 44(3): 870-947.
[3]
Bhatia R,Hill MD,Shobha N, et al. Low rates of acute recanalization with intravenous recombinant tissue plasminogen activator in ischemic stroke: real-world experience and a call for action[J]. Stroke, 2010, 41(10): 2254-2258.
[4]
Heldner MR,Zubler C,Mattle HP, et al. National institutes of health stroke scale score and vessel occlusion in 2152 patients with acute ischemic stroke[J]. Stroke, 2013, 44(4): 1153-1157.
[5]
Christou I,Burgin WS,Alexandrov AV, et al. Arterial status after intravenous TPA therapy for ischaemic stroke. A need for further interventions[J]. Int Angiol, 2001, 200(3): 208-213.
[6]
Lima FO,Furie KL,Silva GS, et al. Prognosis of untreated strokes due to anterior circulation proximal intracranial arterial occlusions detected by use of computed tomography angiography[J]. JAMA Neurol, 2014, 71(2): 151-157.
[7]
Ogawa A,Mori E,Minematsu K, et al. Randomized trial of intraarterial infusion of urokinase within 6 hours of middle cerebral artery stroke: the middle cerebral artery embolism local fibrinolytic intervention trial (MELT) Japan[J]. Stroke, 2007, 38(10): 2633-2639.
[8]
Mehta B,Leslie-Mazwi TM,Chandra RV, et al. Assessing variability in neurointerventional practice patterns for acute ischemic stroke[J]. J Neurointerv Surg, 2013, 5 Suppl 1: i52-i57.
[9]
Broderick JP,Palesch YY,Demchuk AM, et al. Endovascular therapy after intravenous t-PA versus t-PA alone for stroke[J]. N Engl J Med, 2013, 368(10): 893-903.
[10]
Kidwell CS,Jahan R,Gornbein J, et al. A trial of imaging selection and endovascular treatment for ischemic stroke[J]. N Engl J Med, 2013, 368(10): 914-923.
[11]
Ciccone A,Valvassori L,Nichelatti M, et al. Endovascular treatment for acute ischemic stroke[J]. N Engl J Med, 2013, 368(10): 904-913.
[12]
Pereira VM,Gralla J,Davalos A, et al. Prospective, multicenter, single-arm study of mechanical thrombectomy using solitaire flow restoration in acute ischemic stroke[J]. Stroke, 2013, 44(10): 2802-2807.
[13]
Zaidat OO,Castonguay AC,Gupta R, et al. North American solitaire stent retriever acute stroke registry: post-marketing revascularization and clinical outcome results[J]. J Neurointerv Surg, 2014, 6(8): 584-588.
[14]
Mokin M,Dumont TM,Veznedaroglu E, et al. Solitaire flow restoration thrombectomy for acute ischemic stroke: retrospective multicenter analysis of early postmarket experience after FDA approval[J]. Neurosurgery, 2013, 73(1): 19-25.
[15]
Dávalos A,Pereira VM,Chapot R, et al. Retrospective multicenter study of solitaire FR for revascularization in the treatment of acute ischemic stroke[J]. Stroke, 2012, 43(10): 2699-2705.
[16]
Saver JL,Jahan R,Levy EI, et al. Solitaire flow restoration device versus the merci retriever in patients with acute ischaemic stroke (SWIFT): a randomised, parallel-group, non-inferiority trial[J]. Lancet, 2012, 380(9849): 1241-1249.
[17]
Berkhemer OA,Fransen PS,Beumer D, et al. A randomized trial of intraarterial treatment for acute ischemic stroke[J]. N Engl J Med, 2015, 372(1): 11-20.
[18]
Goyal M,Demchuk AM,Menon BK, et al. Randomized assessment of rapid endovascular treatment of ischemic stroke[J]. N Engl J Med, 2015, 372(11): 1019-1030.
[19]
Saver JL,Goyal M,Bonafe A, et al. Stent-retriever thrombectomy after intravenous t-PA vs. t-PA alone in stroke[J]. N Engl J Med, 2015, 372(24): 2285-2295.
[20]
Jovin TG,Chamorro A,Cobo E, et al. Thrombectomy within 8 hours after symptom onset in ischemic stroke[J]. N Engl J Med, 2015, 372(24): 2296-2306.
[21]
Campbell BC,Mitchell PJ,Kleinig TJ, et al. Endovascular therapy for ischemic stroke with perfusion-imaging selection[J]. N Engl J Med, 2015, 372(11): 1009-1018.
[22]
Nogueira RG,Jadhav AP,Haussen DC, et al. Thrombectomy 6 to 24 hours after stroke with a mismatch between deficit and infarct[J]. N Engl J Med, 378(1): 11-21.
[23]
Goyal M,Menon BK,van Zwam WH, et al. Endovascular thrombectomy after large-vessel ischaemic stroke: a meta-analysis of individual patient data from five randomised trials[J]. Lancet, 2016, 387(10029): 1723-1731.
[24]
Wahlgren N,Moreira T,Michel P, et al. Mechanical thrombectomy in acute ischemic stroke: consensus statement by ESO-karolinska stroke update 2014/2015, supported by ESO, ESMINT, ESNR and EAN[J]. Int J Stroke, 2016, 11(1): 134-147.
[25]
Powers WJ,Rabinstein AA,Ackerson T, et al. 2018 guidelines for the early management of patients with acute ischemic stroke: a guideline for healthcare professionals from the American heart association/American stroke association[J]. Stroke, 2018, 49(3): e46-e110.
[26]
Albers GW,Marks MP,Kemp S, et al. Thrombectomy for stroke at 6 to 16 hours with selection by perfusion imaging[J]. N Engl J Med, 2018, 378(8): 708-718.
[27]
Bhogal P,Bücke P,Ganslandt O, et al. Mechanical thrombectomy in patients with M1 occlusion and NIHSS score≤5: a single-centre experience[J]. Stroke Vasc Neurol, 2016, 1(4): 165-171.
[28]
Campbell BC,Hill MD,Rubiera M, et al. Safety and efficacy of solitaire stent thrombectomy: individual patient data meta-analysis of randomized trials[J]. Stroke, 2016, 47(3): 798-806.
[29]
Bracard S,Ducrocq X,Mas JL, et al. Mechanical thrombectomy after intravenous alteplase versus alteplase alone after stroke (THRACE): a randomised controlled trial[J]. Lancet Neurol, 2016, 15(11): 1138-1147.
[30]
Saver JL,Goyal M,van der Lugt A, et al. Time to treatment with endovascular thrombectomy and outcomes from ischemic stroke: a meta-analysis[J]. JAMA, 2016, 316(12): 1279-1288.
[1] 姚金含, 王伟娜, 张玉泉. 妊娠相关深静脉血栓形成患者的预后研究现状[J/OL]. 中华妇幼临床医学杂志(电子版), 2024, 20(04): 367-373.
[2] 石豆豆, 王新星, 王向阳, 刘震洋, 曾淑娟, 仝海波. 急性前循环大血管闭塞机械取栓的研究进展[J/OL]. 中华神经创伤外科电子杂志, 2024, 10(02): 112-116.
[3] 赖凌峰, 黄小飞, 丁聪, 周小兵. 血流导向装置治疗血泡样动脉瘤的临床效果分析[J/OL]. 中华脑科疾病与康复杂志(电子版), 2024, 14(03): 166-170.
[4] 陈雪梅, 潘晓虎, 杨明刚, 刘邦勇, 曹月洲, 贾振宇, 赵林波, 刘圣. 不同基底动脉弯曲度对急性基底动脉闭塞患者取栓治疗的影响[J/OL]. 中华脑科疾病与康复杂志(电子版), 2024, 14(02): 93-99.
[5] 陶栎, 张月辉, 王相明. 急性缺血性卒中院前急救体系的研究进展[J/OL]. 中华脑科疾病与康复杂志(电子版), 2024, 14(01): 56-60.
[6] 范金铭, 翁子瑄, 马武钦, 周斌. 经桡动脉入路在神经介入的发展与应用[J/OL]. 中华介入放射学电子杂志, 2024, 12(03): 261-266.
[7] 孙爱成, 曹月洲, 贾振宇, 赵林波, 施海彬, 刘圣. 低灌注强度比值对老年急性前循环大血管闭塞性脑卒中患者机械取栓治疗预后的影响[J/OL]. 中华介入放射学电子杂志, 2024, 12(01): 15-21.
[8] 王增龙, 顾梅, 杭宇, 刘圣, 施海彬, 包建英. 急性大血管闭塞性脑卒中患者血管内治疗后吞咽障碍发生的危险因素分析[J/OL]. 中华介入放射学电子杂志, 2024, 12(01): 10-14.
[9] 李芳, 戴西望, 王凯, 郭廷昊, 涂江龙. 非瓣膜性心房颤动相关性卒中的治疗研究进展[J/OL]. 中华脑血管病杂志(电子版), 2024, 18(04): 393-397.
[10] 程娅雯, 韩香凝, 朱宁, 何彩莲, 张润宁, 于嘉, 韩建峰, 刘福德. 双路途指导下血管内治疗症状性非急性颈内动脉颅内段闭塞的疗效观察[J/OL]. 中华脑血管病杂志(电子版), 2024, 18(04): 330-337.
[11] 陈鲲鹏, 陆军, 祁鹏, 王俊杰, 胡深, 杨希孟, 邓颖, 裴傲, 王大明. 应用脑膜中动脉栓塞术治疗慢性硬脑膜下血肿的临床观察[J/OL]. 中华脑血管病杂志(电子版), 2024, 18(03): 236-242.
[12] 董坤, 陈海恋, 王景. 血清CircRNA_0003694与老年急性缺血性卒中患者卒中后认知损害的关系[J/OL]. 中华脑血管病杂志(电子版), 2024, 18(03): 230-235.
[13] 许英, 彭采凤, 曾梁楠, 李倩茜, 杨昌美. 未破裂颅内动脉瘤介入治疗患者自我管理干预方案的构建[J/OL]. 中华脑血管病杂志(电子版), 2024, 18(02): 164-170.
[14] 梁文雯, 李征, 万敏, 骆佳莹, 贾伟华. 急性缺血性卒中再灌注治疗后出血转化的研究进展[J/OL]. 中华脑血管病杂志(电子版), 2024, 18(01): 71-80.
[15] 曹杨, 张士永. 伴大血管闭塞的急性前循环缺血性轻型卒中患者机械取栓治疗效果分析[J/OL]. 中华脑血管病杂志(电子版), 2023, 17(06): 576-581.
阅读次数
全文


摘要