Is intravenous thrombolysis necessary before mechanical thrombectomy for acute ischemic stroke?
10.3760/cma.j.issn.1673-4165.2021.05.008
- VernacularTitle:急性缺血性卒中机械血栓切除术前有必要静脉溶栓吗？
- Author:
Yuxiao CHEN
1
;
Yan GUO
;
Yanan LIN
;
Yongping WANG
;
Chao RAN
;
Xiaopei SUN
Author Information
1. 大连医科大学附属第一医院神经内科，大连 116011
- Keywords:
Stroke;
Brain ischemia;
Thrombolytic therapy;
Endovascular procedures;
Thrombectomy;
Treatment outcome
- From:
International Journal of Cerebrovascular Diseases
2021;29(5):358-363
- CountryChina
- Language:Chinese
-
Abstract:
Acute ischemic stroke with large vessel occlusion (AIS-LVO) refers to ischemic stroke caused by large vessel occlusion of internal carotid artery, middle cerebral artery and vertebrobasilar artery, which has the characteristics of large infarct, relatively poor outcome, higher disability and mortality. Therefore, early vascular recanalization and rescue of ischemic penumbra are the key to improve the outcome of patients with AIS-LVO. Mechanical thrombectomy (MT) has a definite effect on AIS-LVO. The current guidelines recommend that MT should be performed on the basis of IVT for AIS-LVO patients without contraindications of intravenous thrombolysis (IVT), the so-called bridging therapy. IVT can increase the risk of bleeding to a certain extent, delay MT and increase the cost of hospitalization. However, there are still many controversies about whether the patients with AIS-LVO can directly perform MT. This article reviews the comparative study of direct MT and bridging therapy in patients with anterior circulation AIS-LVO, hoping to provide reference for clinicians in the treatment of AIS-LVO.
