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J Stroke. 2016 Jan;18(1):102-13. doi: 10.5853/jos.2015.01655. Epub 2016 Jan 29.

Update of the Korean Clinical Practice Guidelines for Endovascular Recanalization Therapy in Patients with Acute Ischemic Stroke.

Author information

1
Department of Neurology, Inje University Ilsan Paik Hospital, Goyang, Korea.
2
Department of Neurology, Seoul National University College of Medicine, Seoul, Korea.
3
Department of Neurology, Hallym University College of Medicine, Anyang, Korea.
4
Department of Radiology, Seoul National University Bundang Hospital, Seongnam, Korea.
5
Department of Neurosurgery, Soonchunhyang University Seoul Hospital, Soonchunhyang University, Seoul, Korea.
6
Department of Radiology, Yonsei University College of Medicine, Seoul, Korea.
7
gDepartment of Neurosurgery, Yeungnam University School of Medicine, Daegu, Korea.
8
Department of Neurology, Seoul National University Bundang Hospital, Seongnam, Korea.
9
Department of Neurology, Yonsei University College of Medicine, Seoul, Korea.
10
Department of Neurosurgery, Seoul National University Bundang Hospital, Seongnam, Korea.
11
Department of Neurosurgery, Soonchunhyang University, Bucheon Hospital, Bucheon, Korea.
12
Department of Radiology, Seoul St.Mary's Hospital, The Catholic University of Korea, Seoul, Korea.
13
Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
14
Department of Neurology, Inha University College of Medicine, Incheon, Korea.

Abstract

Patients with severe stroke due to acute large cerebral artery occlusion are likely to be severely disabled or dead without timely reperfusion. Previously, intravenous tissue plasminogen activator (IV-TPA) within 4.5 hours after stroke onset was the only proven therapy, but IV-TPA alone does not sufficiently improve the outcome of patients with acute large artery occlusion. With the introduction of the advanced endovascular therapy, which enables more fast and more successful recanalization, recent randomized trials consecutively and consistently demonstrated the benefit of endovascular recanalization therapy (ERT) when added to IV-TPA. Accordingly, to update the recommendations, we assembled members of the writing committee appointed by the Korean Stroke Society, the Korean Society of Interventional Neuroradiology, and the Society of Korean Endovascular Neurosurgeons. Reviewing the evidences that have been accumulated, the writing members revised recommendations, for which formal consensus was achieved by convening a panel composed of 34 experts from the participating academic societies. The current guideline provides the evidence-based recommendations for ERT in patients with acute large cerebral artery occlusion regarding patient selection, treatment modalities, neuroimaging evaluation, and system organization.

KEYWORDS:

Acute ischemic stroke; Endovascular recanalization therapy; Guidelines; Large cerebral artery occlusion; Reperfusion; Thrombolysis

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