Stent Retriever (Stentriever) Thrombectomy for Acute Ischemic Stroke
Following the success of five randomized controlled trials comparing intra-arterial recanalization treatment plus standard medical therapy with standard medical treatment, a stent retriever (stentriever) thrombectomy is now recommended as the first-line treatment for acute stroke due to an intracranial large artery occlusion (ILAO) of the anterior circulation [1–11]. As a result, the ability to perform a stentriever thrombectomy is an essential skill for neurointerventionalists, where the learning curve is relatively short for normal cases of endovascular acute stroke treatment . However, in complicated situations, recanalizing an occluded large intracranial artery using a stentriever can become difficult. Therefore, this chapter explains the basic procedure of a stentriever thrombectomy and then suggests some problem-solving techniques for various complex situations.
- 8.Powers WJ, Derdeyn CP, Biller J, et al. 2015 American Heart Association/American Stroke Association Focused update of the 2013 guidelines for the early management of patients with acute ischemic stroke regarding endovascular treatment: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. 2015;46:3020–35.CrossRefPubMedGoogle Scholar
- 10.Hong K-S, Ko S-B, Lee JS, Yu K-H, Rha J-H. Endovascular recanalization therapy in acute stroke: update meta-analysis of randomized controlled trials. J Stroke 2015;17:268–81.Google Scholar
- 19.Mpotsaris A, Bussemeyer M, Buchner H, Weber W. Clinical outcome of neurointerventional emergency treatment of extra- or intracranial tandem occlusions in acute major stroke: antegrade approach with wallstent and solitaire stent retriever. Clin Neuroradiol. 2013;23:207–15.CrossRefPubMedGoogle Scholar
- 23.Sivan-Hoffmann R, Gory B, Armoiry X, et al. (2016) Stent-retriever thrombectomy for acute ischemic stroke with tandem occlusion: a systematic review and meta-analysis. Eur Radiol. 2016 [Epub ahead].Google Scholar