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Mechanical Thrombectomy—A Brief Review of a Revolutionary new Treatment for Thromboembolic Stroke

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Abstract

The recent success of endovascular stroke treatment has heralded a new era in the management of acute ischemic stroke (AIS) with significantly improved outcome for patients. A large number of patients may be amenable to this new treatment and as the evidence expands the number of patients eligible for mechanical thrombectomy continues to increase. Recent evidence suggests that the time window for treatment can be extended up to 24 h after symptom onset for patients with anterior circulation strokes; however, many clinicians and medical professionals may not be aware of these recent changes and it is important that they are kept up-to-date with this rapidly evolving treatment. This review provides an overview of the recent successful trials and highlights important steps that should be instituted in order to achieve rapid reperfusion and optimize the outcome for ischemic stroke patients. It also looks at the remaining controversies facing the field of thrombectomy. A short summary of each of these contentious areas is provided and the current state of the art.

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Funding

This review received no specific grant from any funding agency in the public, commercial or not-for-profit sectors.

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Authors and Affiliations

  1. St. Bartholomew’s and the Royal London Hospital, Whitechapel Road, E1 1BB, London, UK

    Pervinder Bhogal

  2. Departments of Neuroradiology and Clinical Neuroscience, Karolinska University Hospital and Karolinska Institutet, Stockholm, Sweden

    Tommy Andersson & Leonard Yeo

  3. Department of Medical Imaging, AZ Groeninge, 8500, Kortrijk, Belgium

    Tommy Andersson

  4. Department of Neuroradiology, University Hospital of Göttingen, Robert-Koch-Straße 40, 37075, Göttingen, Germany

    Volker Maus

  5. Department of Neuroradiology, University hospital of Aachen, Aachen, Germany

    Anastasios Mpotsaris

  6. Department of Medicine (Neurology), National University Health system and Yong Loo Lin school of medicine, National University of Singapore, Singapore, Singapore

    Leonard Yeo

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Correspondence to Pervinder Bhogal.

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Conflict of interest

T. Andersson is a consultant for Ablynx, Amnis Therapeutics, Medtronic, Cerenovus-Neuravi, Rapid Medical and Stryker. P. Bhogal is consultant for Neurvana Medical and Phenox. L. Yeo has received substantial grant funding from the National Medical Research Council (NMRC), Singapore, substantial grant funding from the Ministry of Health (MOH), Singapore and a moderate grant funding from I2R, A‑STAR, Singapore. V. Maus and A. Mpotsaris declare that they have no competing interests.

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Contributorship statement

T. Andersson edited the manuscript and provided direction of the manuscript.

P. Bhogal drafted the manuscript, edited it and is responsible for the overall content.

L. Yeo drafted the manuscript, edited it and is responsible for the overall content.

V. Maus edited the manuscript and edited it.

A. Mpotsaris edited the manuscript and provided the table.

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Bhogal, P., Andersson, T., Maus, V. et al. Mechanical Thrombectomy—A Brief Review of a Revolutionary new Treatment for Thromboembolic Stroke. Clin Neuroradiol 28, 313–326 (2018). https://doi.org/10.1007/s00062-018-0692-2

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  • DOI: https://doi.org/10.1007/s00062-018-0692-2

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