【摘要】 前循环大血管闭塞(LVO)引起的急性缺血性卒中(AIS)致残致死率高,危害大。静脉溶栓是急性缺血性卒中患者的标准治疗方案。2015年五项具有里程碑意义的随机对照试验发表,首次证明了对前循环缺血性卒中患者,血管内治疗(EVT)优于单独药物治疗。自此,对大血管闭塞导致的急性缺血性卒中,血管内治疗成为标准治疗方案。相对于血管栓塞,动脉粥样硬化引起的大血管闭塞,其血管内治疗更困难,风险更高。本文将对此进行回顾,讨论治疗方法、存在问题及发展。更多还原

【Abstract】 Acute ischaemic stroke due to large vessel occlusion leads to grave neurological morbidity and mortality.The publication of five positive randomised controlled trials of emergency thrombectomy for acute ischaemic stroke in 2015 provided strong evidence to support endovascular reperfusion therapy.Endovascular treatment(EVT) has become a standard treatment for acute ischemic stroke due to large vessel occlusion(LVO) in the anterior circulation.There have been only a few studies about EVT for ICASrelated LVO,and these studies revealed that mechanical thrombectomy with a stent retriever or contact aspiration "was less effective and more time consuming in ICAS-related LVO than in embolic LVO.In this report,we review the results of mechanical thrombectomy using stent retriever or contact aspiration and rescue treatments after failure of mechanical thrombectomy for ICAS-related LVO.Finally,we propose the EVT strategy appropriate for ICAS-related LVO based on a literature review and our experience.更多还原