TY - JOUR T1 - Evolution of thrombectomy approaches and devices for acute stroke: a technical review JF - Journal of NeuroInterventional Surgery JO - J NeuroIntervent Surg SP - 2 LP - 7 DO - 10.1136/neurintsurg-2013-011022 VL - 7 IS - 1 AU - Alejandro M Spiotta AU - M Imran Chaudry AU - Ferdinand K Hui AU - Raymond D Turner AU - Ryan T Kellogg AU - Aquilla S Turk Y1 - 2015/01/01 UR - http://jnis.bmj.com/content/7/1/2.abstract N2 - 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. ER -