脳血管障害の治療の進歩

抄録

After the meta–analysis of 5 major randomized controlled trials (ESCAPE, EXTEND–IA, SWIFT–PRIME, MR–CLEAN, REVASCAT), adding mechanical thrombectomy on the t–PA therapy will become the standard therapy. However, the emergency transport system for acute stroke patients are not operated well in Japan. With the elongation of t–PA therapy to 4.5h after onset of the ischemic stroke, the new era started for the acute stroke therapy. We should make new systems in which how to select the stroke patients for such new therapy. For subacute ~ chronic phase of embolic stroke patients, we can now select 5 anticoagulant therapy, however the way how to select those drugs for which type of patients are not well established.