Percutaneous Clot Removal in Acute Ischemic Stroke

Acute Ischemic Stroke

On average, every 45 seconds in the United States, someone experiences a stroke. Stroke is the number 1 cause of disability: 20% of patients need help walking, 70% cannot return to their previous jobs, and 51% are unable to return to work. Each year, more than twice as many women in the United States die of stroke than breast cancer, and in women older than 45 years, stroke is more common than heart attack.

Clot Removal

The current goal of treatment of acute ischemic stroke is to minimize damage to the brain by restoring blood flow. Several factors including lack of awareness of symptoms of stroke, delay in being seen by a primary care physician, unavailability of tPA at all centers, and the inherent painless nature of stroke make this treatment an option in less than 5% of persons who experience stroke.

With clot retrieval devices, the guidewire and microcatheter are placed beyond the clot, the retriever engages and ensnares the clot, the balloon is inflated, and the clot is pulled into the catheter and removed. In suction thrombectomy, a catheter is navigated over a guidewire into the thrombus within the internal carotid artery, and a syringe is used to aspirate the thrombus. The goal is to extract as much thrombus as possible to minimize the amount of thrombolytic agents needed to achieve recanalization.