机构:[1]Department of Neurosurgery, Tampa, Florida, USA[2]Department of Neurology, University of South Florida, Tampa, Florida, USA[3]Department of Interventional Neurology, Capital Medical University, Beijing, China[4]Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China重点科室诊疗科室神经病学中心神经病学中心首都医科大学附属天坛医院[5]Center for Cerebrovascular Diseases, Taihe Hospital, Shiyan, Hubei, China
The indications for mechanical thrombectomy (MT) have expanded since the American Heart Association/American Stroke Association reported its first guidelines for MT in 2013. Multiple subsequent randomized clinical trials of MT have proved its efficacy, including the DAWN (DWI [diffusion weighted imaging] or CTP [computed tomography perfusion] Assessment with Clinical Mismatch in the Triage of Wake-ttp and Late Presenting Strokes Undergoing Neuro-intervention with Trevo) and DEFUSE-3 (Endovascular Therapy Following Imaging Evaluation for Ischemic Stroke-3) trials. The current guidelines from the American Heart Association/American Stroke Association provide class I support for the use of MT for the following indications: 1) internal carotid artery (ICA)/M1 middle cerebral artery (MCA) occlusion, symptom onset <6 hours, National Institutes of Health Stroke Scale score of >= 6, Alberta Stroke Program Early Computed Tomography Score of >= 6; and 2) large vessel occlusions in the anterior circulation, symptom onset 6-16 hours, and meeting the DAWN or DEFUSE-3 eligibility criteria. Class Ila evidence is also available for the use of MT for large vessel occlusions in the anterior circulation, symptom onset 16-24 hours, and meeting other DAWN eligibility criteria. In clinical practice, these class I and Ila indications for MT have been well followed. However, many other potential indications are available, including 1) M2 or M3 MCA occlusion, symptom onset <6 hours; 2) Alberta Stroke Program Early Computed Tomography Score <6, ICA or M1 MCA occlusion, symptom onset <6 hours; 3) National Institutes of Health Stroke Scale score <6, ICA or M1 occlusion, symptom onset <6 hours; 4) tandem occlusions; and 5) posterior circulation occlusion <6 hours. The present review analyzed the available data to provide support for further prospective clinical trials regarding these potential indications.
第一作者机构:[1]Department of Neurosurgery, Tampa, Florida, USA[5]Center for Cerebrovascular Diseases, Taihe Hospital, Shiyan, Hubei, China
通讯作者:
通讯机构:[1]Department of Neurosurgery, Tampa, Florida, USA[5]Center for Cerebrovascular Diseases, Taihe Hospital, Shiyan, Hubei, China
推荐引用方式(GB/T 7714):
Ren Zeguang,Mokin Maxim,Bauer Clayton T.,et al.Indications for Mechanical Thrombectomy-Too Wide or Too Narrow?[J].WORLD NEUROSURGERY.2019,127:492-499.doi:10.1016/j.wneu.2019.04.116.
APA:
Ren, Zeguang,Mokin, Maxim,Bauer, Clayton T.,Miao, Zhongrong,Burgin, W. Scott&Wang, Yongjun.(2019).Indications for Mechanical Thrombectomy-Too Wide or Too Narrow?.WORLD NEUROSURGERY,127,
MLA:
Ren, Zeguang,et al."Indications for Mechanical Thrombectomy-Too Wide or Too Narrow?".WORLD NEUROSURGERY 127.(2019):492-499