Mechanical Thrombectomy: Emerging Technologies and Techniques

J Stroke Cerebrovasc Dis. 2018 Oct;27(10):2555-2571. doi: 10.1016/j.jstrokecerebrovasdis.2018.05.025. Epub 2018 Jun 28.

Abstract

Background: The treatment of acute ischemic stroke due to large vessel occlusion (LVO) has revolutionized in the last decade. We sought to compile the most relevant literature published about the evolution in treating this disabling and fatal disease.

Methods: A literature review of recent studies describing early treatment options like intravenous tissue plasminogen activator to the latest mechanical thrombectomy (MT) techniques was performed. We described in a chronological order the evolution of LVO treatment.

Results: Recanalization rates with newer techniques and MT devices approach a 90% of effectiveness. Timely interventions have also resulted in better clinical outcomes with approximately 50% of patient achieving functional independence at 90 days. At least 14 new third generation thrombectomy devices are currently being evaluated in in vitro and clinical studies.

Conclusions: The treatment of LVO with MT is feasible and safe. MT is standard of care in treating acute ischemic stroke due to LVO.

Keywords: Thrombectomy; acute ischemic stroke; stent; stentriever.

Publication types

  • Review

MeSH terms

  • Brain Ischemia / diagnostic imaging
  • Brain Ischemia / therapy*
  • Diffusion of Innovation
  • Embolic Protection Devices
  • Forecasting
  • Humans
  • Prosthesis Design
  • Stents
  • Stroke / diagnostic imaging
  • Stroke / therapy*
  • Thrombectomy / adverse effects
  • Thrombectomy / instrumentation
  • Thrombectomy / methods*
  • Thrombectomy / trends
  • Treatment Outcome
  • Vascular Access Devices