Evolution of thrombectomy approaches and devices for acute stroke: a technical review. (2nd January 2014)

• Record Type: Journal Article
• Authors: Spiotta, Alejandro M; Chaudry, M Imran; Hui, Ferdinand K; Turner, Raymond D; Kellogg, Ryan T; Turk, Aquilla S
• Is Part Of: Journal of neurointerventional surgery. Volume 7:Number 1(2015)
• Page Start: 2
• Page End: 7
• Publication Date: 2014-01-02
• Subjects: Stroke -- Thrombectomy; Nervous system -- Surgery -- Periodicals; Cerebrovascular disease -- Surgery -- Periodicals; 617.48
• DOI: 10.1136/neurintsurg-2013-011022
• Languages: English
• ISSNs: 1759-8478

Abstract

Abstract : While intravenous administration of tissue plasminogen activator (tPA) remains the only FDA-approved treatment modality for acute ischemic stroke, many patients do not meet the criteria for intravenous tPA and are offered intra-arterial therapy. Rapid advances in devices and approaches have marked the evolution of thrombectomy over the past decade from rudimentary mechanical disruption, followed by intra-arterial thrombolytic infusions to increasingly effective thrombectomy devices. We review the critical advancements in thrombectomy technique that have evolved and the key anatomic and technical challenges they address, from first-generation Merci retrieval systems to second-generation Penumbra aspiration systems and third-generation stent retrievers, as well as nuances of their uses to maximize their effectiveness. We also highlight more recent advances that offer patients hope for more expedient vessel recanalization.