Efficacy: Mechanical thrombectomy has been shown to be highly effective in the treatment of acute ischemic stroke caused by large vessel occlusion (LVO). Clinical trials, such as the landmark HERMES trial, have demonstrated that mechanical thrombectomy significantly improves functional outcomes and reduces disability in eligible patients.
Time Window: The time window for mechanical thrombectomy has been expanded in recent years. While the standard guideline recommended window is within 6 hours of symptom onset, selected patients can benefit from the procedure up to 24 hours or even beyond, depending on various factors such as imaging findings and clinical presentation.
Global Utilization: The utilization of mechanical thrombectomy has been rapidly increasing worldwide. According to a study published in JAMA Neurology, the use of mechanical thrombectomy for acute ischemic stroke increased from 1.1% in 2010 to 25.9% in 2018 in the United States. Similar trends have been observed in other developed countries.
Improved Outcomes: Mechanical thrombectomy has significantly improved the outcomes for patients with acute ischemic stroke. Studies have reported higher rates of functional independence and reduced mortality compared to standard medical treatment alone.
Guidelines and Recommendations: International stroke treatment guidelines, such as those from the American Heart Association/American Stroke Association (AHA/ASA) and the European Stroke Organisation (ESO), strongly recommend mechanical thrombectomy as a standard treatment for eligible patients with acute ischemic stroke due to LVO.
Imaging Selection: Advanced imaging techniques, such as CT perfusion or MRI diffusion-weighted imaging, are used to select appropriate patients for mechanical thrombectomy. These imaging modalities help identify patients with salvageable brain tissue and predict the likelihood of a good clinical outcome.
Access and Disparities: Access to mechanical thrombectomy can vary across regions and healthcare systems. Disparities in access may be influenced by factors such as geographical location, availability of specialized stroke centers, expertise of healthcare professionals, and healthcare infrastructure.
Ongoing Research: Research in the field of mechanical thrombectomy is ongoing. Studies are exploring various aspects, including the optimal selection of patients, refinement of procedural techniques, use of adjunctive medications, and the role of artificial intelligence in image analysis and decision-making.
