RT Journal Article
SR Electronic
T1 Evolution of thrombectomy approaches and devices for acute stroke: a technical review
JF Journal of NeuroInterventional Surgery
JO J NeuroIntervent Surg
FD BMJ Publishing Group Ltd.
SP 2
OP 7
DO 10.1136/neurintsurg-2013-011022
VO 7
IS 1
A1 Alejandro M Spiotta
A1 M Imran Chaudry
A1 Ferdinand K Hui
A1 Raymond D Turner
A1 Ryan T Kellogg
A1 Aquilla S Turk
YR 2015
UL http://jnis.bmj.com/content/7/1/2.abstract
AB 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.