Abstract：
Endovascular treatment (EVT) for acute ischemic stroke is one of the most efficacious and effective treatments in medicine, yet globally, its implementation remains limited. Patterns of EVT underutilization exist in virtually any health care system and range from a complete lack of access to selective undertreatment of certain patient subgroups. In this review, we outline different patterns of EVT underutilization and possible causes. We discuss common challenges and bottlenecks that are encountered by physicians, patients, and other stakeholders when trying to establish and expand EVT services in different scenarios and possible pathways to overcome these challenges. Lastly, we discuss the importance of implementation research studies, strategic partnerships, and advocacy efforts to mitigate EVT underutilization.
摘要：
血管内治疗(EVT)是目前医学上最有效、最有效的治疗方法之一。然而在全球范围内，其实施仍然有限。EVT未充分利用的模式几乎存在于任何医疗保健系统中，从完全无法获得某些患者亚组的选择性治疗不足。在这次审查中,我们概述了EVT未充分利用的不同模式和可能的原因。我们讨论了医生遇到的常见挑战和瓶颈，病人,以及其他利益相关者在尝试在不同的场景中建立和扩展EVT服务以及克服这些挑战的可能途径时。最后,我们讨论了实施研究的重要性，战略伙伴关系,和倡导努力减轻EVT的利用不足。
