Stroke Treatment Academic Industry Roundtable: The Next Generation of Endovascular Trials.
Stroke Treatment Academic Industry Roundtable: The Next Generation of Endovascular Trials.
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DOI：
10.1161/strokeaha.116.013578
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发表时间：
2016-10
期刊：
影响因子：
8.3
通讯作者：
STAIR IX Consortium
中科院分区：
文献类型：
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作者：
Jovin TG;Albers GW;Liebeskind DS;STAIR IX Consortium
STAIR（脑卒中治疗学术行业圆桌会议）旨在通过学术界、产业界和监管机构之间的合作，推进急性脑卒中治疗的发展。为了实现这一目标，并基于最近可获得的血管内治疗（ET）在大血管闭塞性卒中中的益处的一级证据，制定了STAIR IX共识建议，概述了未来ET研究的优先事项。确定了推进该领域的三个关键方向：(1)发展大血管闭塞性卒中ET治疗系统，(2)发展ET辅助治疗方法，(3)探索ET在近期试验中研究不足的患者群体中的临床益处。方法学问题，如最佳试验设计和结果测量也已解决。护理战略系统的发展应着眼于确保符合条件的患者广泛获得体外循环治疗，并尽可能缩短再灌注时间。辅助治疗的发展包括神经保护方法、辅助微循环/侧支增强策略和围手术期管理。寻求扩大符合条件的患者群体的未来研究重点是确定ET在超过常规时间窗口的患者、基线缺血性核心病变大的患者和其他重要亚组中的益处。大血管闭塞性脑卒中ET的研究重点是改善护理系统，研究有效的辅助疗法，并探讨是否可以扩大患者的资格。
The STAIR (Stroke Treatment Academic Industry Roundtable) meeting aims to advance acute stroke therapy development through collaboration between academia, industry, and regulatory institutions. In pursuit of this goal and building on recently available level I evidence of benefit from endovascular therapy (ET) in large vessel occlusion stroke, STAIR IX consensus recommendations were developed that outline priorities for future research in ET. Three key directions for advancing the field were identified: (1) development of systems of care for ET in large vessel occlusion stroke, (2) development of therapeutic approaches adjunctive to ET, and (3) exploring clinical benefit of ET in patient population insufficiently studied in recent trials. Methodological issues such as optimal trial design and outcome measures have also been addressed. Development of systems of care strategies should be geared both toward ensuring broad access to ET for eligible patients and toward shortening time to reperfusion to the minimum possible. Adjunctive therapy development includes neuroprotective approaches, adjuvant microcirculatory/collateral enhancing strategies, and periprocedural management. Future research priorities seeking to expand the eligible patient population are to determine benefit of ET in patients presenting beyond conventional time windows, in patients with large baseline ischemic core lesions, and in other important subgroups. Research priorities in ET for large vessel occlusion stroke are to improve systems of care, investigate effective adjuvant therapies, and explore whether patient eligibility could be expanded.