title: Current status of mechanical thrombectomy for acute stroke treatment.
abstract: Acute ischemic stroke is a morbid and disabling medical condition with a significant social and economic impact throughout the world. Intravenous thrombolysis (IVT) has been the first line treatment for patients presenting up to 4.5 hours after symptom onset for many years. Endovascular stroke treatment has been used successfully as rescue therapy after failed IVT; in patients with contraindications to rtPA or presenting outside the 4.5-hour window. The effectiveness of IVT is high for distal thrombi but significantly lower for proximal occlusions. Endovascular treatment has been revolutionized by the evolution from intra-arterial thrombolysis and first generation mechanical devices to the current generation of stent retrievers and aspiration systems with large bore catheters. These devices have been associated with excellent revascularization, improved clinical outcomes, shorter procedure times and reduced device and procedure related complications. We report the current literature, clinical standards and perspectives on mechanical thrombectomy in acute ischemic stroke.
authors: Division of Neuroradiology, Department of Medical Imaging, Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada; Division of Neurosurgery, Department of Surgery, Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada; Interventional Neuroradiology Unit, Service of Neuroradiology, University Hospitals of Geneva, Rue Gabrielle-Perret-Gentil, 4, 1211 Geneva, Switzerland. Electronic address: vitormpbr@hotmail.com.
authors: Vitor Mendes
authors: VM
authors: Pereira
authors: Interventional Neuroradiology Unit, Service of Neuroradiology, University Hospitals of Geneva, Rue Gabrielle-Perret-Gentil, 4, 1211 Geneva, Switzerland. Electronic address: hasan.yilmaz@hcuge.ch.
authors: Hasan
authors: H
authors: Yilmaz
authors: Interventional Neuroradiology Unit, Service of Neuroradiology, University Hospitals of Geneva, Rue Gabrielle-Perret-Gentil, 4, 1211 Geneva, Switzerland. Electronic address: alain.pellaton@hcuge.ch.
authors: Alain
authors: A
authors: Pellaton
authors: Division of Neuroradiology, Department of Medical Imaging, Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada. Electronic address: leeanne.slater@gmail.com.
authors: Lee-Anne
authors: LA
authors: Slater
authors: Division of Neuroradiology, Department of Medical Imaging, Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada; Division of Neurosurgery, Department of Surgery, Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada. Electronic address: timo.krings@uhn.ca.
authors: Timo
authors: T
authors: Krings
authors: Interventional Neuroradiology Unit, Service of Neuroradiology, University Hospitals of Geneva, Rue Gabrielle-Perret-Gentil, 4, 1211 Geneva, Switzerland. Electronic address: karl-olof.lovblad@hcuge.ch.
authors: Karl-Olof
authors: KO
authors: Lovblad
mesh_terms: D002533:Cerebral Angiography / Q000379:methods*; D019317:Evidence-Based Medicine; D006801:Humans; D061185:Mechanical Thrombolysis / Q000295:instrumentation* / Q000379:methods*; D020521:Stroke / Q000175:diagnosis* / Q000628:therapy*; D025321:Surgery, Computer-Assisted / Q000379:methods*; D016896:Treatment Outcome
keywords: Acute stroke; Endovascular treatment; Stent retriever; Thrombectomy