期刊
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY
卷 67, 期 22, 页码 2645-2655出版社
ELSEVIER SCIENCE INC
DOI: 10.1016/j.jacc.2015.12.077
关键词
acute ischemic stroke; endovascular therapy; randomized clinical trials; stroke centers; thrombectomy
资金
- Toshiba
- Apama
- Augmenix
- Axtria
- Boston Scientific
- Claret Medical Inc.
- Ellipse
- Endomation
- Medina Medical
- NextPlain
- Ostial Corporation
- Photolitec
- Silk Road
- StimSox
- ValenTx
- Valor Medical
- Abbott for carotid training for physicians
- National Institutes of Health/National Institute of Neurological Disorders
- Stroke/National Institute of Biomedical Imaging and Bioengineering and University at Buffalo
- Hotspur
- Intratech Medical
- Blockade Medical
- Lazarus Effect
- Abbott Vascular
- Cordis
- EndoTex
- EPI
- ev3
- Guidant
- Kerberos
- Medtronic
- Micrus
- Zimmer
- Access Closure Inc.
- Primus
Five recently published randomized trials of endovascular therapy versus medical management, including intravenous thrombolysis, demonstrated strong positive data in support of intra-arterial thrombectomy procedures. The American Heart Association/American Stroke Association released a focused update of the 2013 guidelines on the early management of acute ischemic strokes to specifically incorporate the findings of the 5 positive trials. In this review, we examine the key results of those trials and the principal changes in the updated guidelines. We discuss the ongoing and future changes in stroke systems of care, with an emphasis on the role of pre-hospital stroke triage, interhospital transfer, and the 2 main levels of stroke center certification (primary and comprehensive). (C) 2016 by the American College of Cardiology Foundation.
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