%0 Journal Article %A Alejandro M Spiotta %A M Imran Chaudry %A Ferdinand K Hui %A Raymond D Turner %A Ryan T Kellogg %A Aquilla S Turk %T Evolution of thrombectomy approaches and devices for acute stroke: a technical review %D 2015 %R 10.1136/neurintsurg-2013-011022 %J Journal of NeuroInterventional Surgery %P 2-7 %V 7 %N 1 %X 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. %U https://jnis.bmj.com/content/neurintsurg/7/1/2.full.pdf