Mechanical embolectomy.
Mechanical embolectomy in acute ischemic stroke employs the use of novel endovascular devices to revascularize occluded intracerebral arteries. Devices like the Merci Retiever and other endovascular snares, laser thrombectomy and rheolytic/obliterative microcatheters, intracranial balloon angioplasty and stenting, and intra-arterial and transcranial ultrasound-enhanced chemical thrombolysis are intended to improve tissue rescue and diminish reperfusion hemorrhage while broadening the population eligible for therapy. Patient selection with MRI- and CT-based stroke protocols can detect tissue at risk and may obviate the classic limitations of the stroke therapeutic time window. These devices are being developed and modified at a rapid pace, requiring mounting endovascular expertise, and are being used successfully alone or in conjunction with chemical thrombolysis with relative safety.
Department of Neurology and Neuroscience, New York Presbyterian Hospital, Weill Medical College of Cornell University, 525 East 68th Street, New York, NY 10021, USA.
Jeffrey M
JM
Katz
Y Pierre
YP
Gobin
Alan Z
AZ
Segal
Howard A
HA
Riina
D002545:Brain Ischemia / Q000209:etiology*; D017128:Embolectomy / Q000295:instrumentation*; D006801:Humans; D020766:Intracranial Embolism / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery*; D053685:Laser Therapy / Q000295:instrumentation; D018810:Magnetic Resonance Angiography; D011183:Postoperative Complications / Q000145:classification / Q000517:prevention & control; D013997:Time Factors; D014057:Tomography, X-Ray Computed