1文献来源Lansberg MG,Mlynash M,Hamilton S,et al.Association of thrombectomy with stroke outcomes among patient subgroups:Secondary analyses of the DEFUSE 3 randomized clinical trial[J].JAMA Neurol,2019,76(4):447-453....1文献来源Lansberg MG,Mlynash M,Hamilton S,et al.Association of thrombectomy with stroke outcomes among patient subgroups:Secondary analyses of the DEFUSE 3 randomized clinical trial[J].JAMA Neurol,2019,76(4):447-453.2证据水平1b。3背景多项随机临床试验表明,如果在症状出现后6小时内开始治疗,血管内血栓切除术是治疗缺血性脑卒中的有效方法。而最近,2项随机临床试验,DAWN和DEFUSE 3研究证明经过先进的神经影像技术筛选的患者可以大大延长血栓切除的时间窗,这些成果导致了美国指南的修改。展开更多
1文献来源Coutinho JM,Liebeskind DS,Slater LA,et al.Combined intravenous thrombolysis and thrombectomy vs thrombectomy alone for acute ischemic stroke:A pooled analysis of the SWIFT and STAR studies[J].JAMA Neurol,2017...1文献来源Coutinho JM,Liebeskind DS,Slater LA,et al.Combined intravenous thrombolysis and thrombectomy vs thrombectomy alone for acute ischemic stroke:A pooled analysis of the SWIFT and STAR studies[J].JAMA Neurol,2017,74(3):268-274.2证据水平2b。3背景机械取栓(mechanical thrombectomy,MT)可以改善大血管闭塞所致急性缺血性卒中的临床结局。MT患者静脉溶栓(intravenous thrombolysis,IVT)是否具有附加的获益尚不清楚。展开更多
1文献来源Thomalla G,Simonsen CZ,Boutitie F,et al.MRI⁃guided thrombolysis for stroke with unknown time of onset[J].N Engl J Med,2018,379(7):611-622.2证据水平1b。3背景阿替普酶(一种重组组织纤溶酶原激活剂)静脉溶栓治疗是发...1文献来源Thomalla G,Simonsen CZ,Boutitie F,et al.MRI⁃guided thrombolysis for stroke with unknown time of onset[J].N Engl J Med,2018,379(7):611-622.2证据水平1b。3背景阿替普酶(一种重组组织纤溶酶原激活剂)静脉溶栓治疗是发病4.5小时内急性缺血性脑卒中的标准药物。14%~27%的脑卒中患者不能明确具体的发病时间,通常是因为患者从睡眠中醒来时才识别出脑卒中症状。展开更多
1文献来源Bourcier R,Goyal M,Liebeskind DS,et al.Association of time from stroke onset to groin puncture with quality of reperfusion after mechanical thrombectomy:A meta⁃analysis of individual patient data from 7 rando...1文献来源Bourcier R,Goyal M,Liebeskind DS,et al.Association of time from stroke onset to groin puncture with quality of reperfusion after mechanical thrombectomy:A meta⁃analysis of individual patient data from 7 randomized clinical trials[J].JAMA Neurol,2019,76(4):405-411.2证据水平1b。3背景在大血管闭塞(large vessel occlusion,LVO)所致急性缺血性脑卒中(acute ischemic stroke,AIS)领域中,当前学界聚焦于缩短再灌注时间、识别患者的最优影像检查以及评估最佳治疗技术方法。脑血管取栓有效再通与患者的临床结局显著相关,成功再灌注通常指改良脑梗死溶栓分级(modified thrombolysis in cerebral infarction,mTICI)评定为2b和3级血流的患者。展开更多
文摘1文献来源Lansberg MG,Mlynash M,Hamilton S,et al.Association of thrombectomy with stroke outcomes among patient subgroups:Secondary analyses of the DEFUSE 3 randomized clinical trial[J].JAMA Neurol,2019,76(4):447-453.2证据水平1b。3背景多项随机临床试验表明,如果在症状出现后6小时内开始治疗,血管内血栓切除术是治疗缺血性脑卒中的有效方法。而最近,2项随机临床试验,DAWN和DEFUSE 3研究证明经过先进的神经影像技术筛选的患者可以大大延长血栓切除的时间窗,这些成果导致了美国指南的修改。
文摘1文献来源Coutinho JM,Liebeskind DS,Slater LA,et al.Combined intravenous thrombolysis and thrombectomy vs thrombectomy alone for acute ischemic stroke:A pooled analysis of the SWIFT and STAR studies[J].JAMA Neurol,2017,74(3):268-274.2证据水平2b。3背景机械取栓(mechanical thrombectomy,MT)可以改善大血管闭塞所致急性缺血性卒中的临床结局。MT患者静脉溶栓(intravenous thrombolysis,IVT)是否具有附加的获益尚不清楚。
文摘1文献来源Thomalla G,Simonsen CZ,Boutitie F,et al.MRI⁃guided thrombolysis for stroke with unknown time of onset[J].N Engl J Med,2018,379(7):611-622.2证据水平1b。3背景阿替普酶(一种重组组织纤溶酶原激活剂)静脉溶栓治疗是发病4.5小时内急性缺血性脑卒中的标准药物。14%~27%的脑卒中患者不能明确具体的发病时间,通常是因为患者从睡眠中醒来时才识别出脑卒中症状。
文摘1文献来源Bourcier R,Goyal M,Liebeskind DS,et al.Association of time from stroke onset to groin puncture with quality of reperfusion after mechanical thrombectomy:A meta⁃analysis of individual patient data from 7 randomized clinical trials[J].JAMA Neurol,2019,76(4):405-411.2证据水平1b。3背景在大血管闭塞(large vessel occlusion,LVO)所致急性缺血性脑卒中(acute ischemic stroke,AIS)领域中,当前学界聚焦于缩短再灌注时间、识别患者的最优影像检查以及评估最佳治疗技术方法。脑血管取栓有效再通与患者的临床结局显著相关,成功再灌注通常指改良脑梗死溶栓分级(modified thrombolysis in cerebral infarction,mTICI)评定为2b和3级血流的患者。
