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2019 급성 허혈뇌졸중 환자에서 혈관내재개통치료 진료지침 개정

2019 Update of the Korean Clinical Practice Guidelines of Stroke for Endovascular Recanalization Therapy in Patients with Acute Ischemic Stroke

대한신경과학회지 2020년 38권 2호 p.77 ~ 87
고상배 ( Ko Sang-Bae ) - Seoul National University College of Medicine Seoul National University Hospital Department of Neurology

박홍균 ( Park Hong-Kyun ) - Seoul National University College of Medicine Seoul National University Hospital Department of Neurology
김병문 ( Kim Byung-Moon ) - Yonsei University College of Medicine Severance Hospital Department of Radiology
허지회 ( Heo Ji-Hoe ) - Yonsei University College of Medicine Severance Hospital Department of Neurology
나정호 ( Rha Joung-Ho ) - Inha University School of Medicine Inha University Hospital Department of Neurology
 ( Kwon Sun-U. ) - University of Ulsan College of Medicine Asan Medical Center Department of Neurology
김종성 ( Kim Jong-S. ) - University of Ulsan College of Medicine Asan Medical Center Department of Neurology
이병철 ( Lee Byung-Chul ) - Hallym University College of Medicine Hallym University Sacred Heart Hospital Department of Neurology
서상현 ( Suh Sang-Hyun ) - Yonsei University College of Medicine Gangnam Severance Hospital Department of Radiology
정철규 ( Jung Cheol-Kyu ) - Seoul National University College of Medicine Seoul National University Bundang Hospital Department of Radiology
정해웅 ( Jeong Hae-Woong ) - Inje University College of Medicine Inje University Busan Paik Hospital Department of Radiology
강동훈 ( Kang Dong-Hun ) - Kyungpook National University School of Medicine Department of Neurosurgery
배희준 ( Bae Hee-Joon ) - Seoul National University College of Medicine Seoul National University Bundang Hospital Department of Neurology
윤벙우 ( Yoon Byung-Woo ) - Seoul National University College of Medicine Seoul National University Hospital Department of Neurology
홍근식 ( Hong Keun-Sik ) - Inje University College of Medicine Inje University Ilsan Paik Hospital Department of Neurology

Abstract


Endovascular recanalization therapy (ERT) has been a standard of care for patients with acute ischemic stroke due to large artery occlusion (LAO) within 6 hours after onset since the five landmark ERT trials up to 2015 demonstrated its clinical benefit. Recently, two randomized clinical trials demonstrated that ERT, even in the late time window up to 16 hours or 24 hours after last known normal time, improved the outcome of patients who had a target mismatch defined as either clinical-core mismatch or perfusion-core mismatch, which prompted the update of national guidelines in several countries.
Accordingly, to provide evidence-based and up-to-date recommendations for ERT in patients with acute LAO in Korea, the Clinical Practice Guidelines Committee of the Korean Stroke Society decided to revise the previous Korean Clinical Practice Guidelines of Stroke for ERT. For this update, the members of the writing group were appointed by the Korean Stroke Society and the Korean Society of Interventional Neuroradiology. After thorough reviewing the updated evidence from two recent trials and relevant literature, the writing members revised recommendations, for which formal consensus was achieved by convening an expert panel composed of 45 experts from the participating academic societies. The current guidelines are intended to help healthcare providers, patients, and their caregivers make their well-informed decisions and to improve the quality of care regarding ERT. The ultimate decision for ERT in a particular patient must be made in light of circumstances specific to that patient.

키워드

Practice guideline; Cerebral infarction; Cerebral artery diseases; Carotid artery thrombosis; Reperfusion
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