机械取栓在醒后卒中治疗中应用的研究进展

Application of mechanical thrombectomy in the patients with wake-up stroke

起病时间不明、短期治疗结局不佳的醒后卒中(wake-up stroke,WUS)约占所有卒中的25%;且由于以上2个特点,如何选择WUS治疗方案仍在探索中。机械取栓是急性缺血性脑卒中(acute ischemic stroke,AIS)的一线治疗,DAWN和DEFUSE-3研究证明其治疗时间窗可扩大至24 h;且研究发现通过CT灌注成像等影像学检查,选择具有"临床评分和影像学上梗死核心体积不匹配"的WUS患者行血管内治疗仍安全而有效。该文就近年来机械取栓在WUS治疗中的应用做一总结。

Wake-up stroke(WUS),which is characterized by the uncertain onset time and poor short-term outcome,accounts for 25%of stroke.Due to the above two points,how to choose the treatment methods remains to be researched.The mechanical thrombectomy is the first-line treatment of acute ischemic stroke(AIS).DAWN and DEFUSE-3 studies have recently demonstrated that the treatment window can be expanded to 24 hours,so the endovascular treatment may be effective and safe in some WUS patients according to the existence of“the mismatch of clinical score and imaging infart core”by CT perfusion imaging and other modern imaging methods.This article summarized the application of mechanical thrombectomy in WUS treatment in recent years.