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March 2018

Thrombectomy Options for Acute Ischemic Stroke: Which Way to Go?

Author Affiliations
  • 1Department of Neurology and Erasmus MC Stroke Center, Erasmus MC, University Medical Center, Rotterdam, the Netherlands
JAMA Neurol. 2018;75(3):276-278. doi:10.1001/jamaneurol.2017.3985

In this issue of JAMA Neurology, Nogueira et al1 report the results of a trial comparing aspiration-assisted stent retrieval with aspiration alone in patients with acute ischemic stroke. In a few years’ time, mechanical thrombectomy has become a standard for treatment of acute ischemic stroke caused by proximal intracranial thromboembolic occlusions. This progress is amazing when one considers where we stood in 2013, with 3 neutral trials of intra-arterial treatment for stroke.2 The next 5 trials that were published in quick succession in early 20153-7 and 2 later ones8,9 all indicated that early thrombectomy has a strong beneficial effect on stroke outcome. The number of patients needed to treat to let 1 patient improve substantially is less than 3.10 These trials could be successful because they used imaging to identify the patients with an intracranial occlusion, and for the treatment, they all used state-of-the-art retrievable stents in almost every patient.

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