Recanalization therapy for acute ischemic stroke, part 2: mechanical intra-arterial technologies.
Stroke therapy has been revolutionized in the past two decades with the widespread implementation of chemical thrombolysis for acute stroke. However, chemical thrombolysis continues to be limited in its efficacy secondary to relatively short time windows and a high associated risk of hemorrhage. In an attempt to minimize hemorrhagic complications and extend the available therapeutic window, mechanical devices designed specifically for thrombus removal, clot obliteration, and arterial revascularization have experienced a recent surge in development and utilization. As such, chemical thrombolytics now represent only one of many options in acute stroke therapy. These new mechanical devices have extended the potential treatment window and now provide alternatives to patients who do not respond to conventional intravenous thrombolysis. This review will discuss the development of these devices, supporting literature, and the individual strengths that each engenders towards a life-saving therapy for stroke.
Department of Neurosurgery, University of Florida, Gainesville, FL, USA.
Saeed
S
Ansari
Maryam
M
Rahman
Douglas J
DJ
McConnell
Michael F
MF
Waters
Brian L
BL
Hoh
J
J
Mocco
D017130:Angioplasty; D002545:Brain Ischemia / Q000150:complications* / Q000601:surgery*; D002536:Cerebral Arteries / Q000601:surgery*; D006801:Humans; D019635:Neurosurgical Procedures; D015607:Stents; D020521:Stroke / Q000209:etiology* / Q000601:surgery*; D015912:Thrombolytic Therapy; D014656:Vascular Surgical Procedures