Major ischemic strokes secondary to proximal artery occlusions are responsible for significant morbidity and mortality. Owing to extensive clot burden, these strokes are poorly responsive to intravenous tissue plasminogen activator. The introduction of endovascular therapy, particularly mechanical devices, has resulted in markedly improved recanalization rates of large vessel occlusions. With increasing experience with the Penumbra Stroke System and the 054 reperfusion catheter, there has been further improvement in TIMI 2 and 3 revascularization rates with faster times to vessel opening. The aim of this technical review is to convey various tips and tricks learnt from this experience.
- arteriovenous malformation
- flow diverter
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Competing interests AJY receives research support from Penumbra Inc for the Core Imaging Lab for the START trial. DF is a consultant and/or serves on the speakers' bureau for Penumbra, Stryker Neurovascular, Genentech and Codman. AST and DVH are consultants for Penumbra Inc. JAH is a shareholder in Intratech.
Provenance and peer review Not commissioned; externally peer reviewed.