title: Evolution of Endovascular Therapy in Acute Stroke: Implications of Device Development.
abstract: Intravenous thrombolysis is an effective treatment for acute ischaemic stroke. However, vascular recanalization rates remain poor especially in the setting of large artery occlusion. On the other hand, endovascular intra-arterial therapy addresses this issue with superior recanalization rates compared with intravenous thrombolysis. Although previous randomized controlled studies of intra-arterial therapy failed to demonstrate superiority, the failings may be attributed to a combination of inferior intra-arterial devices and suboptimal selection criteria. The recent results of several randomized controlled trials have demonstrated significantly improved outcomes, underpinning the advantage of newer intra-arterial devices and superior recanalization rates, leading to renewed interest in establishing intra-arterial therapy as the gold standard for acute ischaemic stroke. The aim of this review is to outline the history and development of different intra-arterial devices and future directions in research.
authors.affiliation: Comprehensive Stroke Centre, Royal Melbourne Hospital, Parkville, Victoria, Australia.
authors.forename: Adithya
authors.initials: A
authors.lastname: Balasubramaian
authors.affiliation: Comprehensive Stroke Centre, Royal Melbourne Hospital, Parkville, Victoria, Australia.
authors.forename: Peter
authors.initials: P
authors.lastname: Mitchell
authors.affiliation: Comprehensive Stroke Centre, Royal Melbourne Hospital, Parkville, Victoria, Australia.
authors.forename: Richard
authors.initials: R
authors.lastname: Dowling
authors.affiliation: Comprehensive Stroke Centre, Royal Melbourne Hospital, Parkville, Victoria, Australia.
authors.forename: Bernard
authors.initials: B
authors.lastname: Yan
keywords: Acute Ishemic Stroke; Clot Retrieval; Endovascular; Mechanical Thrombectomy; Stentriever