Stroke is a leading cause of death and disability worldwide. It occurs when blood supply to the brain is interrupted, resulting in brain cell death. Acute ischemic stroke (AIS) accounts for approximately 87% of all strokes and is characterized by a clot that blocks a blood vessel in the brain. Large vessel occlusion (LVO) is a particularly devastating presentation of AIS, often leading to severe disability and death. However, advances in technology have led to a game-changing treatment for AIS due to LVO: mechanical thrombectomy by stent retrievers.
Mechanical thrombectomy is a minimally invasive procedure that involves inserting a catheter into an artery in the groin or wrist and guiding it to the blocked blood vessel in the brain. A stent retriever is then deployed, which removes the clot by trapping it within the stent and allowing it to be pulled out of the vessel. This procedure has become increasingly popular due to its effectiveness and safety in treating AIS due to LVO.
Studies have consistently demonstrated the effectiveness of mechanical thrombectomy by stent retrievers. One of the most influential studies, the 2015 Extending the Time for Thrombolysis in Emergency Neurological Deficits-Intra-Arterial (EXTEND-IA) trial, showed that patients who underwent mechanical thrombectomy with stent retrievers had significantly higher rates of functional independence at 90 days compared to those who received standard care (71% vs. 40%, respectively). Furthermore, mechanical thrombectomy has been shown to be effective even in patients who do not meet the standard criteria for intravenous thrombolysis.
Another advantage of mechanical thrombectomy by stent retrieval is its safety profile. The procedure has a low rate of complications, with the most common being groin hematoma, which can be easily treated. Additionally, mechanical thrombectomy has been shown to be safe and effective even in elderly patients and those with comorbidities such as diabetes and hypertension.
Mechanical thrombectomy by stent retrievers is an advanced treatment option for AIS due to LVO. Its effectiveness and safety have been demonstrated in numerous studies, making it a promising method for improving outcomes in patients with AIS. However, it is important to note that the success of mechanical thrombectomy is highly dependent on timely intervention. Patients who receive treatment within the first few hours of symptom onset have higher rates of functional independence and lower rates of complications.
All in all, mechanical thrombectomy by stent retriever device is a highly effective and safe treatment option for patients with AIS due to LVO. The procedure has the potential to greatly improve outcomes and reduce disability and mortality rates associated with stroke. Future research should focus on increasing public awareness and improving access to timely and appropriate stroke care to maximize the benefits of mechanical thrombectomy.