[Thrombectomy : Stent retriever vs aspiration].

Abstract

Besides intravenous thrombolysis, endovascular therapy (EVT) is also a standard treatment option for acute ischemic stroke. The clinical efficacy and safety of this procedure was proven in 2015 by several randomized controlled trials. The aim of EVT is to achieve the fastest possible recanalization of an occluded artery supplying the brain and, thus, reperfusion of the brain tissue. In EVT, the thrombus is thrombectomized mechanically using wire-mounted self-expanding stents (so-called stent retrievers) and/or aspirated through aspiration catheters. The extent of brain tissue reperfusion influences the clinical outcome of the affected patients. High reperfusion scores (Thrombolysis in Cerebral Infarction [TICI]) correlate positively with more favorable clinical outcomes. However, even after achieving high TICI scores, the clinical outcome of stroke patients with large vessel occlusions varies considerably. There are many reasons for this. In addition to the collateral supply and the perfusion pressure of the affected brain area, the period of tissue ischemia plays a particularly important role in preservation of brain function. In addition to the TICI score, the number of thrombectomy maneuvers performed and consequently the duration of the intervention has an influence on the clinical outcome of the treated patients.