动脉粥样硬化相关的前循环大血管闭塞所致急性缺血性卒中的血管内治疗

·综 述·

Endovascular treatment of acute stroke due to atherosclerotic stenosis-related large vessel occlusion

［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 ICAS-related 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.