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Review
. 2011 Feb;32(2):238-43.
doi: 10.3174/ajnr.A2346. Epub 2011 Jan 13.

Endovascular stroke treatment today

I Q Grunwald  1 , A K Wakhloo, S Walter, A J Molyneux, J V Byrne, S Nagel, A L Kühn, M Papadakis, K Fassbender, J S Balami, M Roffi, H Sievert, A Buchan
Affiliations
Review

Endovascular stroke treatment today

I Q Grunwald et al. AJNR Am J Neuroradiol. 2011 Feb.

Abstract

The purpose of this study was to review current treatment options in acute ischemic stroke, focusing on the latest advances in the field of mechanical recanalization. These devices recently made available for endovascular intracranial thrombectomy show great potential in acute stroke treatments. Compelling evidence of their recanalization efficacy comes from current mechanical embolectomy trials. In addition to allowing an extension of the therapeutic time window, mechanical recanalization devices can be used without adjuvant thrombolytic therapy, thus diminishing the intracranial bleeding risk. Therefore, these devices are particularly suitable in patients in whom thrombolytic therapy is contraindicated. IV and IA thrombolysis and bridging therapy are viable options in acute stroke treatment. Mechanical recanalization devices can potentially have a clinically relevant impact in the interventional treatment of stroke, but at the present time, a randomized study would be beneficial.

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Figures

Fig 1.
Fig 1.
A, The BONnet consists of a self-expanding nitinol braiding with polyamide filaments passing through the interior to enlarge the surface area and enable better fixation of the thrombus mass. The system can be either put distal to the thrombus or released into the thrombus. B, The CRC is based on a fiber work of polyamide filaments whose lengths from proximal to distal end increase. The CRC has an additional nitinol thread cage at the proximal end of its fiber brush. This nitinol cage gives it a higher radial range. C, The Phenox pCR is based on perpendicularly oriented polyamide microfilaments that create an attenuated palisade.
Fig 2.
Fig 2.
The Penumbra System is based on an aspiration platform that includes reperfusion microcatheters connected to an aspiration pump. A teardrop-shaped separator is advanced and retracted within the lumen of the reperfusion catheter to debulk the clot for ease of aspiration.
Fig 3.
Fig 3.
Solitaire FR stent (ev3). A self-expanding stent that can be fully deployed and then completely retrieved. It is not approved for sale in the United States.
See this image and copyright information in PMC

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