2019 年 36 巻 3 号 p. 294-296
In 2014 to 2015, five positive trials of endovascular therapy for anterior circulation large vessel occlusion (AC–LVO) were published. In Japanese guidelines for the management of stroke, mechanical therombectomy (MT) for AC–LVO was recommended as a grade A therapy in 2017. In 2018, DAWN trial and DEFUSE3 trial demonstrated the benefit of MT in late time window AC–LVO patients. These trials limited in AC–LVO. The benefit of MT for posterior circulation LVO (PC–LVO) remains unproven.
In another issue, not every LVO patients can receive MT because MT capable hospitals are limited. If MT eligible patient is transported to MT incapable hospital, patient have to be transferred to MT capable hospital. Stroke bypass in consideration of MT or intrahospital relationship must be reconstructed.
