Research progress of mechanical thrombectomy in cerebral artery occlusion_West China Medical Journal

Authors：

PAN Xiaohua ^1,2 , LIU Guorong ³ ,  WU Bo ¹ , FANG Yong ³ , ZHU Qiange ¹

1. Department of Neurology, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;
2. Department of Neurology, Baotou Eighth Hospital, Baotou, Inner Mongolia 014040, P. R. China;
3. Department of Neurology, Baotou Central Hospital, Baotou, Inner Mongolia 014040, P. R. China;

Corresponding author：

WU Bo, Email: dragonwb@126.com

Keywords：

Acute ischemic stroke; mechanical thrombectomy; review

DOI：

10.7507/1002-0179.202007081

Video：

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Stroke is a disease that seriously affects the quality of life of patients. Its main characteristics are that the incidence rate is increasing year by year, the risk of death is high, and the prognosis of the disease is poor. For patients with acute cerebral artery occlusive ischemic stroke, intravenous thrombolysis alone has a low recanalization rate and poor long-term prognosis. With the development of interventional treatment technology for cerebrovascular disease, intravascular interventional treatment methods such as arterial thrombolysis, stent placement, and mechanical thrombectomy are more and more applied in the ultra-early stage of acute ischemic stroke. This article reviews the progress of mechanical thrombectomy in the treatment of cerebral artery occlusion in patients with acute ischemic stroke.

Citation： PAN Xiaohua, LIU Guorong, WU Bo, FANG Yong, ZHU Qiange. Research progress of mechanical thrombectomy in cerebral artery occlusion. West China Medical Journal, 2022, 37(9): 1395-1399. doi: 10.7507/1002-0179.202007081 Copy

1.	Wang W, Jiang B, Sun H, et al. Prevalence, incidence, and mortality of stroke in China: results from a nationwide population-based survey of 480 687 adults. Circulation, 2017, 135(8): 759-771.
2.	GBD 2016 Neurology Collaborators. Global, regional, and national burden of neurological disorders, 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet Neurol, 2019, 18(5): 459-480.
3.	Ferrell AS, Britz GW. Developments on the horizon in the treatment of neurovascular problems. Surg Neurol Int, 2013, 4(Suppl 1): S31-S37.
4.	Smith WS, Sung G, Saver J, et al. Mechanical thrombectomy for acute ischemic stroke: final results of the multi MERCI trial. Stroke, 2008, 39(4): 1205-1212.
5.	Penumbra Pivotal Stroke Trial Investigators. The penumbra pivotal stroke trial: safety and effectiveness of a new generation of mechanical devices for clot removal in intracranial large vessel occlusive disease. Stroke, 2009, 40(8): 2761-2768.
6.	Kabbasch C, Mpotsaris A, Chang DH, et al. Mechanical thrombectomy with the Trevo ProVue device in ischemic stroke patients: does improved visibility translate into a clinical benefit?. J Neurointerv Surg, 2016, 8(8): 778-782.
7.	Lapergue B, Blanc R, Gory B, et al. Effect of endovascular contact aspiration vs stent retriever on revascularization in patients with acute ischemic stroke and large vessel occlusion: the ASTER randomized clinical trial. JAMA, 2017, 318(5): 443-452.
8.	Martini M, Mocco J, Turk A, et al. ‘Real-world’ comparison of first-line direct aspiration and stent retriever mechanical thrombectomy for the treatment of acute ischemic stroke in the anterior circulation: a multicenter international retrospective study. J Neurointerv Surg, 2019, 11(10): 957-963.
9.	Turk AS 3rd, Siddiqui A, Fifi JT, et al. Aspiration thrombectomy versus stent retriever thrombectomy as first-line approach for large vessel occlusion (COMPASS): a multicentre, randomised, open label, blinded outcome, non-inferiority trial. Lancet, 2019, 393(10175): 998-1008.
10.	Ye G, Lu J, Qi P, et al. Firstline a direct aspiration first pass technique versus firstline stent retriever for acute basilar artery occlusion: a systematic review and meta-analysis. J Neurointerv Surg, 2019, 11(8): 740-746.
11.	Kang DH, Kim JW, Kim BM, et al. Need for rescue treatment and its implication: stent retriever versus contact aspiration thrombectomy. J Neurointerv Surg, 2019, 11(10): 979-983.
12.	Tsang COA, Cheung IHW, Lau KK, et al. Outcomes of stent retriever versus aspiration-first thrombectomy in ischemic stroke: a systematic review and meta-analysis. AJNR Am J Neuroradiol, 2018, 39(11): 2070-2076.
13.	Nishi H, Ishii A, Nakahara I, et al. Different learning curves between stent retrieval and a direct aspiration first-pass technique for acute ischemic stroke. J Neurosurg, 2018, 129(6): 1456-1463.
14.	Saver JL, Jahan R, Levy EI, et al. Solitaire flow restoration device versus the Merci Retriever in patients with acute ischaemic stroke (SWIFT): a randomised, parallel-group, non-inferiority trial. Lancet, 2012, 380(9849): 1241-1249.
15.	Sheth SA, Jahan R, Levy EI, et al. Rapid learning curve for Solitaire FR stent retriever therapy: evidence from roll-in and randomised patients in the SWIFT trial. J Neurointerv Surg, 2016, 8(4): 347-352.
16.	Hentschel KA, Daou B, Chalouhi N, et al. Comparison of non-stent retriever and stent retriever mechanical thrombectomy devices for the endovascular treatment of acute ischemic stroke. J Neurosurg, 2017, 126(4): 1123-1130.
17.	Fahed R, Di Maria F, Rosso C, et al. A leap forward in the endovascular management of acute basilar artery occlusion since the appearance of stent retrievers: a single-center comparative study. J Neurosurg, 2017, 126(5): 1578-1584.
18.	Zaidat OO, Castonguay AC, Nogueira RG, et al. TREVO stent-retriever mechanical thrombectomy for acute ischemic stroke secondary to large vessel occlusion registry. J Neurointerv Surg, 2018, 10(6): 516-524.
19.	Saber H, Rajah GB, Kherallah RY, et al. Comparison of the efficacy and safety of thrombectomy devices in acute stroke: a network meta-analysis of randomized trials. J Neurointerv Surg, 2018, 10(8): 729-734.
20.	Berkhemer OA, Fransen PS, Beumer D, et al. A randomized trial of intraarterial treatment for acute ischemic stroke. N Engl J Med, 2015, 372(1): 11-20.
21.	Jovin TG, Chamorro A, Cobo E, et al. Thrombectomy within 8 hours after symptom onset in ischemic stroke. N Engl J Med, 2015, 372(24): 2296-2306.
22.	Saver JL, Goyal M, Bonafe A, et al. Stent-retriever thrombectomy after intravenous t-PA vs. t-PA alone in stroke. N Engl J Med, 2015, 372(24): 2285-2295.
23.	Campbell BC, Mitchell PJ, Kleinig TJ, et al. Endovascular therapy for ischemic stroke with perfusion-imaging selection. N Engl J Med, 2015, 372(11): 1009-1018.
24.	Goyal M, Demchuk AM, Menon BK, et al. Randomized assessment of rapid endovascular treatment of ischemic stroke. N Engl J Med, 2015, 372(11): 1019-1030.
25.	Goyal M, Menon BK, van Zwam WH, et al. Endovascular thrombectomy after large-vessel ischaemic stroke: a meta-analysis of individual patient data from five randomised trials. Lancet, 2016, 387(10029): 1723-1731.
26.	Campbell BC, Hill MD, Rubiera M, et al. Safety and efficacy of solitaire stent thrombectomy: individual patient data meta-analysis of randomized trials. Stroke, 2016, 47(3): 798-806.
27.	Shireman TI, Wang K, Saver JL, et al. Cost-effectiveness of solitaire stent retriever thrombectomy for acute ischemic stroke: results from the SWIFT-PRIME trial (solitaire with the intention for thrombectomy as primary endovascular treatment for acute ischemic stroke). Stroke, 2017, 48(2): 379-387.
28.	Nogueira RG, Jadhav AP, Haussen DC, et al. Thrombectomy 6 to 24 hours after stroke with a mismatch between deficit and infarct. N Engl J Med, 2018, 378(1): 11-21.
29.	Albers GW, Marks MP, Kemp S, et al. Thrombectomy for stroke at 6 to 16 hours with selection by perfusion imaging. N Engl J Med, 2018, 378(8): 708-718.
30.	Zaidat OO, Bozorgchami H, Ribó M, et al. Primary results of the multicenter ARISE II study (Analysis of Revascularization in Ischemic Stroke with EmboTrap). Stroke, 2018, 49(5): 1107-1115.
31.	Machi P, Costalat V, Lobotesis K, et al. Solitaire FR thrombectomy system: immediate results in 56 consecutive acute ischemic stroke patients. J Neurointerv Surg, 2018, 10(Suppl 1): i27-i32.
32.	Mokin M, Sonig A, Sivakanthan S, et al. Clinical and procedural predictors of outcomes from the endovascular treatment of posterior circulation strokes. Stroke, 2016, 47(3): 782-788.
33.	Baik SH, Jung C, Kim BM, et al. Mechanical thrombectomy for tandem vertebrobasilar stroke: characteristics and treatment outcome. Stroke, 2020, 51(6): 1883-1885.
34.	中国卒中学会, 中国卒中学会神经介入分会, 中华预防医学会卒中预防与控制专业委员会介入学组. 急性缺血性卒中血管内治疗中国指南 2018. 中国卒中杂志, 2018, 13(7): 706-729.
35.	Eesa M, Burns PA, Almekhlafi MA, et al. Mechanical thrombectomy with the Solitaire stent: is there a learning curve in achieving rapid recanalization times?. J Neurointerv Surg, 2014, 6(9): 649-651.

1. Wang W, Jiang B, Sun H, et al. Prevalence, incidence, and mortality of stroke in China: results from a nationwide population-based survey of 480 687 adults. Circulation, 2017, 135(8): 759-771.
2. GBD 2016 Neurology Collaborators. Global, regional, and national burden of neurological disorders, 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet Neurol, 2019, 18(5): 459-480.
3. Ferrell AS, Britz GW. Developments on the horizon in the treatment of neurovascular problems. Surg Neurol Int, 2013, 4(Suppl 1): S31-S37.
4. Smith WS, Sung G, Saver J, et al. Mechanical thrombectomy for acute ischemic stroke: final results of the multi MERCI trial. Stroke, 2008, 39(4): 1205-1212.
5. Penumbra Pivotal Stroke Trial Investigators. The penumbra pivotal stroke trial: safety and effectiveness of a new generation of mechanical devices for clot removal in intracranial large vessel occlusive disease. Stroke, 2009, 40(8): 2761-2768.
6. Kabbasch C, Mpotsaris A, Chang DH, et al. Mechanical thrombectomy with the Trevo ProVue device in ischemic stroke patients: does improved visibility translate into a clinical benefit?. J Neurointerv Surg, 2016, 8(8): 778-782.
7. Lapergue B, Blanc R, Gory B, et al. Effect of endovascular contact aspiration vs stent retriever on revascularization in patients with acute ischemic stroke and large vessel occlusion: the ASTER randomized clinical trial. JAMA, 2017, 318(5): 443-452.
8. Martini M, Mocco J, Turk A, et al. ‘Real-world’ comparison of first-line direct aspiration and stent retriever mechanical thrombectomy for the treatment of acute ischemic stroke in the anterior circulation: a multicenter international retrospective study. J Neurointerv Surg, 2019, 11(10): 957-963.
9. Turk AS 3rd, Siddiqui A, Fifi JT, et al. Aspiration thrombectomy versus stent retriever thrombectomy as first-line approach for large vessel occlusion (COMPASS): a multicentre, randomised, open label, blinded outcome, non-inferiority trial. Lancet, 2019, 393(10175): 998-1008.
10. Ye G, Lu J, Qi P, et al. Firstline a direct aspiration first pass technique versus firstline stent retriever for acute basilar artery occlusion: a systematic review and meta-analysis. J Neurointerv Surg, 2019, 11(8): 740-746.
11. Kang DH, Kim JW, Kim BM, et al. Need for rescue treatment and its implication: stent retriever versus contact aspiration thrombectomy. J Neurointerv Surg, 2019, 11(10): 979-983.
12. Tsang COA, Cheung IHW, Lau KK, et al. Outcomes of stent retriever versus aspiration-first thrombectomy in ischemic stroke: a systematic review and meta-analysis. AJNR Am J Neuroradiol, 2018, 39(11): 2070-2076.
13. Nishi H, Ishii A, Nakahara I, et al. Different learning curves between stent retrieval and a direct aspiration first-pass technique for acute ischemic stroke. J Neurosurg, 2018, 129(6): 1456-1463.
14. Saver JL, Jahan R, Levy EI, et al. Solitaire flow restoration device versus the Merci Retriever in patients with acute ischaemic stroke (SWIFT): a randomised, parallel-group, non-inferiority trial. Lancet, 2012, 380(9849): 1241-1249.
15. Sheth SA, Jahan R, Levy EI, et al. Rapid learning curve for Solitaire FR stent retriever therapy: evidence from roll-in and randomised patients in the SWIFT trial. J Neurointerv Surg, 2016, 8(4): 347-352.
16. Hentschel KA, Daou B, Chalouhi N, et al. Comparison of non-stent retriever and stent retriever mechanical thrombectomy devices for the endovascular treatment of acute ischemic stroke. J Neurosurg, 2017, 126(4): 1123-1130.
17. Fahed R, Di Maria F, Rosso C, et al. A leap forward in the endovascular management of acute basilar artery occlusion since the appearance of stent retrievers: a single-center comparative study. J Neurosurg, 2017, 126(5): 1578-1584.
18. Zaidat OO, Castonguay AC, Nogueira RG, et al. TREVO stent-retriever mechanical thrombectomy for acute ischemic stroke secondary to large vessel occlusion registry. J Neurointerv Surg, 2018, 10(6): 516-524.
19. Saber H, Rajah GB, Kherallah RY, et al. Comparison of the efficacy and safety of thrombectomy devices in acute stroke: a network meta-analysis of randomized trials. J Neurointerv Surg, 2018, 10(8): 729-734.
20. Berkhemer OA, Fransen PS, Beumer D, et al. A randomized trial of intraarterial treatment for acute ischemic stroke. N Engl J Med, 2015, 372(1): 11-20.
21. Jovin TG, Chamorro A, Cobo E, et al. Thrombectomy within 8 hours after symptom onset in ischemic stroke. N Engl J Med, 2015, 372(24): 2296-2306.
22. Saver JL, Goyal M, Bonafe A, et al. Stent-retriever thrombectomy after intravenous t-PA vs. t-PA alone in stroke. N Engl J Med, 2015, 372(24): 2285-2295.
23. Campbell BC, Mitchell PJ, Kleinig TJ, et al. Endovascular therapy for ischemic stroke with perfusion-imaging selection. N Engl J Med, 2015, 372(11): 1009-1018.
24. Goyal M, Demchuk AM, Menon BK, et al. Randomized assessment of rapid endovascular treatment of ischemic stroke. N Engl J Med, 2015, 372(11): 1019-1030.
25. Goyal M, Menon BK, van Zwam WH, et al. Endovascular thrombectomy after large-vessel ischaemic stroke: a meta-analysis of individual patient data from five randomised trials. Lancet, 2016, 387(10029): 1723-1731.
26. Campbell BC, Hill MD, Rubiera M, et al. Safety and efficacy of solitaire stent thrombectomy: individual patient data meta-analysis of randomized trials. Stroke, 2016, 47(3): 798-806.
27. Shireman TI, Wang K, Saver JL, et al. Cost-effectiveness of solitaire stent retriever thrombectomy for acute ischemic stroke: results from the SWIFT-PRIME trial (solitaire with the intention for thrombectomy as primary endovascular treatment for acute ischemic stroke). Stroke, 2017, 48(2): 379-387.
28. Nogueira RG, Jadhav AP, Haussen DC, et al. Thrombectomy 6 to 24 hours after stroke with a mismatch between deficit and infarct. N Engl J Med, 2018, 378(1): 11-21.
29. Albers GW, Marks MP, Kemp S, et al. Thrombectomy for stroke at 6 to 16 hours with selection by perfusion imaging. N Engl J Med, 2018, 378(8): 708-718.
30. Zaidat OO, Bozorgchami H, Ribó M, et al. Primary results of the multicenter ARISE II study (Analysis of Revascularization in Ischemic Stroke with EmboTrap). Stroke, 2018, 49(5): 1107-1115.
31. Machi P, Costalat V, Lobotesis K, et al. Solitaire FR thrombectomy system: immediate results in 56 consecutive acute ischemic stroke patients. J Neurointerv Surg, 2018, 10(Suppl 1): i27-i32.
32. Mokin M, Sonig A, Sivakanthan S, et al. Clinical and procedural predictors of outcomes from the endovascular treatment of posterior circulation strokes. Stroke, 2016, 47(3): 782-788.
33. Baik SH, Jung C, Kim BM, et al. Mechanical thrombectomy for tandem vertebrobasilar stroke: characteristics and treatment outcome. Stroke, 2020, 51(6): 1883-1885.
34. 中国卒中学会, 中国卒中学会神经介入分会, 中华预防医学会卒中预防与控制专业委员会介入学组. 急性缺血性卒中血管内治疗中国指南 2018. 中国卒中杂志, 2018, 13(7): 706-729.
35. Eesa M, Burns PA, Almekhlafi MA, et al. Mechanical thrombectomy with the Solitaire stent: is there a learning curve in achieving rapid recanalization times?. J Neurointerv Surg, 2014, 6(9): 649-651.

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Research progress of mechanical thrombectomy in cerebral artery occlusion

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