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The Aspirations of Direct Aspiration for Thrombectomy in Ischemic Stroke: A Critical Analysis
Tommy Andersson,Martin Wiesmann,Omid Nikoubashman,Anil Gopinathan,Pervinder Bhogal,Leonard L.L. Yeo 대한뇌졸중학회 2019 Journal of stroke Vol.21 No.1
The treatment of acute ischemic stroke by mechanical thrombectomy has been revolutionary, however most of the clinical trials were done with the use a stent retriever. At the same time, an alternative technique of thrombectomy through direct aspiration with a large bore distal access catheter at the face of the clot is rapidly gaining popularity. Nonetheless, the data supporting this new technique is not yet as mature as that available on stent retrievers. This review is a critical analysis of the evidence supporting the principle of direct aspiration thrombectomy and a discussion of its potential strengths and weaknesses in comparison to the available studies on stent retrievers. While this is by no means a conclusive review, it should serve as a yardstick of where the science is currently, and what are the next trials that are necessary.
Thrombectomy in Acute Ischemic Stroke: Challenges to Procedural Success
Albert J. Yoo,Tommy Andersson 대한뇌졸중학회 2017 Journal of stroke Vol.19 No.2
The overwhelming clinical benefit of intra-arterial stroke therapy owes to the major advance inrevascularization brought on by the current generation of thrombectomy devices. Nevertheless,there remains a sizeable proportion of patients for whom substantial reperfusion cannot beachieved or is achieved too late. This article addresses the persistent challenges that faceneurointerventionists and reviews technical refinements that may help to mitigate these obstaclesto procedural success. Insights from in vitro modeling and clinical research are organized arounda conceptual framework that examines the interaction between the device, the thrombus and thevessel wall.