<International Circulation>：That’s very interesting research. In terms of thrombolytic therapy is there any other new research that you find particularly interesting?

　　《国际循环网》：这个研究非常有趣。就溶栓治疗而言，还有什么您认为有趣的试验可以给我们介绍？
　　Kaste Markku：Not really as far as randomized trials but you are well aware that there is thrombectomy. There are mechanical ways， just like in coronary heart disease where you go into the artery and remove the thrombi and leave the stent. So there are these kinds of on-going trials. There is tough competition. The FDA has approved quite a few of these mechanical stents and stent retrievers. But none of these has been ever been tested in randomized trials， such as a placebo-controlled trial.  The series are just open series in which doctors have treated patients selected as optimal candidates not for thrombolysis but for mechanical thrombectomy. That’s one of the problems. But many institutes， such as my own， have reached the problem of when do you introduce these new technologies. If you see from the angiography and very extensive thrombi， which is unlike your result with the alteplase. So you start the infusion with the alteplase and then call your radiological colleague and ask if there’s an angio-lab free， available and if there is then you transfer the patient and continue with arterial thrombectomy. So it’s like a rescue treatment after t-PA.

　　Kaste Markku：关于临床随机试验我没有要说的了，但是，你应该知道血栓切除术。就像治疗冠心病一样，进入动脉移除血栓，放入支架。现在有很多这方面试验。这个领域竞争很激烈，FDA已批准几个机械支架和支架取栓器，但是都没有在随机化试验（如安慰剂对照试验）中测试过。这个诊疗过程是开放的，患者选择标准为适合机械血栓切除术而非溶栓治疗，这是问题之一。很多研究机构也包括我们，研究中发现另一个问题，即何时采用新技术。如果血管造影发现非常广泛的血栓，且与alteplase治疗结果不同，你会先用alteplase灌注，然后在血管试验室行动脉血栓切除术，类似于t-PA后抢救治疗。
 

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