Article Text

Download PDFPDF
Commentary on ’The POST trial: initial post-market experience of the Penumbra system: revascularization of large vessel occlusion in acute ischemic stroke in the United States and Europe'
  1. Joshua A Hirsch
  1. Correspondence to Dr Joshua A Hirsch, NeuroEndovascular Program, Massachusetts General Hospital, Boston, MA 02114, USA; hirsch{at}

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

Emergent large vessel occlusion (ELVO) is a ’hot topic' for neuroInterventionalists (NI) in 2018.1 In 1996, the US Food and Drug Administration (FDA) approved the use of  IV rtPA for the treatment of acute ischemic stroke within three hours of symptom onset.2 Intra-arterial prourokinase was studied in the PROACT trials but was not approved for use based, in part, on concerns that related to hemorrhagic complications present in the treatment arm of PROACT II.3 4 This disappointment in chemical thrombolysis pushed mechanical thrombectomy (MT) forward.

In 2004, the FDA approved the flexible, looped nitinol wire called MERCI for the indication of intracranial clot retrieval in patients with acute ischemic stroke.5 6 Penumbra originally employed two different treatment options: a reperfusion catheter and separator device; and  direct thrombus extraction with a ring retriever while a balloon-guide catheter was used to temporarily arrest flow.7 The Penumbra Pivotal trial that exclusively utilized the first approach described above resulted …

View Full Text


  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial, or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Not required.

  • Provenance and peer review Commissioned; internally peer reviewed.

Linked Articles