Akut �skemik �nmeli Hastalarda Endovaskuler Tedavi: Randomize Kontrollu Calismalardan, G�ncel Tedavi Onerilerine

Asil, Talip; G�rka�, Erdem; Giray, Semih; Aslan, Abdullah Taha; Eren, Alper; �zkul, Ay�a; �nalan, Ay�enur; Acar, Bilgehan At�lgan; Akp�nar, �etin K�r�ad; Ayta�, Emrah; Balgetir, Ferhat; Do�an, Hasan; Ar�, Mehmet; Ayka�, �zlem; Boncuk Ula�, Sena; G�ren, �mit; Uysal Kocaba�, Zehra; �zdemir, Atilla �zcan

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Akut �skemik �nmeli Hastalarda Endovaskuler Tedavi: Randomize Kontrollu Calismalardan, G�ncel Tedavi Onerilerine [T�rk Beyin Damar Hast Derg]

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Akut �skemik �nmeli Hastalarda Endovaskuler Tedavi: Randomize Kontrollu Calismalardan, G�ncel Tedavi Onerilerine

Talip Asil¹, Erdem G�rka�², Semih Giray³, Abdullah Taha Aslan⁴, Alper Eren⁵, Ay�a �zkul⁶, Ay�enur �nalan², Bilgehan At�lgan Acar⁷, �etin K�r�ad Akp�nar⁸, Emrah Ayta�⁹, Ferhat Balgetir⁹, Hasan Do�an⁸, Mehmet Ar�⁶, �zlem Ayka�¹⁰, Sena Boncuk Ula�¹¹, �mit G�ren¹⁰, Zehra Uysal Kocaba�¹⁰, Atilla �zcan �zdemir¹⁰
¹Biruni Universitesi Tip Fakultesi Hastanesi, N�roloji Klinigi, �stanbul
²Saglik Bilimleri Universitesi Kartal Dr. Lutfi Kirdar Sehir Hastanesi, N�roloji Klinigi, �nme Merkezi, �stanbul
³Gaziantep �niversitesi T�p Fak�ltesi, N�roloji Anabilim Dali Emekli ��retim �yesi, Gaziantep
⁴Calgary Stroke Program University of Calgary Neuroscience Program, Kanada
⁵Ataturk Universitesi Tip Fakultesi, Noroloji Anabilim Dali, Erzurum
⁶Ba�ak�ehir �am ve Sakura �ehir Hastanesi N�roloji Klini�i, �stanbul
⁷Sakarya �niversitesi T�p Fak�ltesi, N�roloji Anabilim Dal�, Sakarya
⁸Samsun �niversitesi Samsun E�itim ve Ara�t�rma Hastanesi, N�roloji Klinigi, Samsun
⁹Firat Universitesi Tip Fakultesi, Noroloji Anabilim Dal�, Diyarbak�r
¹⁰Eski�ehir Osmangazi �niversitesi T�p Fak�ltesi, N�roloji Anabilim Dali, Eski�ehir
¹¹Bagimsiz Arast�rmac�

Akut �skemik inmenin tedavisinde son 3 dekat boyunca h�zl� geli�meler kaydedilmi�tir. Endovaskuler tedaviler b�y�k damar okl�zyonu olan hastalarda �zellikle penumbra varl��nda alt�n standart tedavi olarak yer buldu, ancak iskemik inmenin do�as� gere�i daha distal okl�zyonlar, geni� infarkt alan� olan hastalar gibi bir �ok tart�smal� hasta grubunda tedavi kararlari almak gereklili�i olu�mu�tur. T�m d�nyada olu�turulan ulusal ve uluslararasi rehberler arac�l�� ile daha fazla hastada iyi klinik sonu�lara ula�mak hedeflenmektedir. Son y�llarda �ok hizli geli�melerin oldu�u akut iskemik inmenin endovaskuler tedavisi hakk�nda yazilan bu derleme ile, bu konuda yapilan b�y�k cal��malar, metaanalizler ve uluslararasi rehberlerdeki �neriler �zetlenmi� ve �lkemiz i�in �neriler olu�turulmaya �al��lm��t�r.

Anahtar Kelimeler: Akut iskemik inme, mekanik trombektomi, endovaskuler tedavi.

Endovascular Treatment in Acute Ischemic Stroke: From Randomized Studies to Current Treatments

Talip Asil¹, Erdem G�rka�², Semih Giray³, Abdullah Taha Aslan⁴, Alper Eren⁵, Ay�a �zkul⁶, Ay�enur �nalan², Bilgehan At�lgan Acar⁷, �etin K�r�ad Akp�nar⁸, Emrah Ayta�⁹, Ferhat Balgetir⁹, Hasan Do�an⁸, Mehmet Ar�⁶, �zlem Ayka�¹⁰, Sena Boncuk Ula�¹¹, �mit G�ren¹⁰, Zehra Uysal Kocaba�¹⁰, Atilla �zcan �zdemir¹⁰
¹Biruni University Hospital, Department of Neurology, �stanbul, T�rkiye
²University of Sa�l�k Bilimleri, Kartal Dr. Lutfi Kirdar Sehir Hospital, Department of Neurology, Strok Unit, �stanbul, T�rkiye
³University of Gaziantep Faculty of Medicine, Department of Neurology, Gaziantep, T�rkiye
⁴Calgary Stroke Program University of Calgary Neuroscience Program, Canada
⁵University of Ataturk Faculty of Medicine, Department of Neurology, Erzurum, T�rkiye
⁶Basaksehir Cam ve Sakura City Hospital Department of Neurology, �stanbul, T�rkiye
⁷University of Sakarya Faculty of Medicine, Department of Neurology, Sakarya, T�rkiye
⁸University of Samsun Samsun Training and Research Hospital, Department of Neurology, Samsun, T�rkiye
⁹University of Firat Faculty of Medicine Department of Neurology, Diyarbak�r, T�rkiye
¹⁰Eskisehir Osmangazi University Faculty of Medicine, Department of Neurology, Eski�ehir, T�rkiye
¹¹Independent Researcher

Rapid advances have been made in the treatment of acute ischemic stroke over the last 3 decades. Endovascular treatments have become the gold standard treatment in patients with large vessel occlusion, especially in the presence of penumbra, but due to the nature of ischemic stroke, it has become necessary to make treatment decisions in many controversial patient groups such as patients with distal occlusions and lpatients with arge core infarct. It is aimed to achieve good clinical results in more patients through national and international guidelines created all over the world. In this review written about the endovascular treatment of acute ischemic stroke, where there have been very rapid developments in recent years, large studies, meta-analyses and recommendations in international guidelines on this subject are summarized and recommendations are tried to be made for our country.

Keywords: Acute ischemic stroke, mechanical trombectomy, endovascular treatment.

Sorumlu Yazar: Talip Asil, T�rkiye
Makale Dili: T�rk�e

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Akut �skemik �nmeli Hastalarda Endovaskuler Tedavi: Randomize Kontrollu Calismalardan, G�ncel Tedavi Onerilerine

Endovascular Treatment in Acute Ischemic Stroke: From Randomized Studies to Current Treatments