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KMID : 1142120150170020127
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Journal of Stroke
2015 Volume.17 No. 2 p.127 ~ p.137
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Evolution of Endovascular Therapy in Acute Stroke: Implications of Device Development
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Balasubramaian Adithya
Mitchell Peter
Dowling Richard
Yan Bernard
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Abstract
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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.
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KEYWORD
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Mechanical Thrombectomy, Acute Ishemic Stroke, Clot Retrieval, Endovascular, Stentriever
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