J Korean Neurol Assoc.
2016 Nov;34(5):297-311. 10.17340/jkna.2016.4.3.
Update of the Korean Clinical Practice Guidelines for Endovascular Recanalization Therapy in Patients with Acute Ischemic Stroke
- Affiliations
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- 1Department of Neurology, Inje University Ilsan Paik Hospital, Goyang, Korea.
- 2Department of Neurology, Seoul National University College of Medicine, Seoul, Korea.
- 3Department of Neurology, Hallym University College of Medicine, Anyang, Korea.
- 4Department of Radiology, Seoul National University Bundang Hospital, Seongnam, Korea.
- 5Department of Neurosurgery, Soonchunhyang University Seoul Hospital, Soonchunhyang University, Seoul, Korea.
- 6Department of Radiology, Yonsei University College of Medicine, Seoul, Korea.
- 7Department of Neurosurgery, Yeungnam University School of Medicine, Daegu, Korea.
- 8Department of Neurology, Seoul National University Bundang Hospital, Seongnam, Korea.
- 9Department of Neurology, Yonsei University College of Medicine, Seoul, Korea.
- 10Department of Neurosurgery, Seoul National University Bundang Hospital, Seongnam, Korea.
- 11Department of Neurosurgery, Soonchunhyang University, Bucheon Hospital, Bucheon, Korea.
- 12Department of Radiology, Seoul St.Mary's Hospital, The Catholic University of Korea, Seoul, Korea.
- 13Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
- 14Department of Neurology, Inha University College of Medicine, Incheon, Korea. jhrha@inha.ac.kr
- KMID: 2359440
- DOI: http://doi.org/10.17340/jkna.2016.4.3
Abstract
- Patients with severe stroke due to acute large cerebral artery occlusion are likely to be severely disabled or die if reperfusion is not achieved in a timely manner. Intravenous tissue plasminogen activator (IV-TPA) administered within 4.5 hours after stroke onset was previously 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 that enables faster and more successful recanalization, recent randomized trials consecutively and consistently demonstrated the benefit of adding endovascular recanalization therapy (ERT) to IV-TPA. Accordingly, to update the recommendations, we assembled members of a writing committee appointed by the Korean Stroke Society, the Korean Society of Interventional Neuroradiology, and the Society of Korean Endovascular Neurosurgeons. The writing committee revised recommendations based on a review of the accumulated evidence, and a formal consensus was achieved by convening a panel of 34 experts from the participating academic societies. The current guideline provides evidence-based recommendations for ERT in patients with acute large cerebral artery occlusion regarding patient selection, treatment modalities, neuroimaging evaluation, and system organization.
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