Evolution of endovascular mechanical thrombectomy for acute ischemic stroke

Table 1 Summary of endovascular mechanical thrombectomy devices

Device	Manufacturer	Mechanism
Merci retriever	Concentric Medical	Thrombus retrieved with helical snare
Penumbra system	Penumbra Inc.	Thromboaspiration
Solitaire FR	eV3 Endovascular	Thrombus incorporated into struts of deployed stent
Trevo Pro	Stryker neurovascular	Thrombus incorporated into struts of deployed stent

Table 2 Comparison of randomized trials of endovascular thrombectomy for AIS

Trial	Treatment arms	n	Revascularizationa (%)	Good outcomebc (%)	Symptomatic ICH (%)	Mortalityb (%)
SWIFT	Merci Retriever	55	67	33	11	38
	Solitaire FR	58	89	58	2	17
TREVO 2	Merci Retriever	90	60	22	2	24
	Trevo Pro	88	86	40	4	33
SYNTHESISd	IVT	181	NR	35	6	6
	EVT	181	NR	30	6	8
IMS III	IVT	222	NR	39	6	22
	IVT + EVT	434	e	41	6	19
MR Rescue	Penumbral, IVT	34	93	26	6	21
	Penumbral, EVT	34	67	21	9	18
	Nonpenumbral, IVT	20	78	10	0	30
	Nonpenumbral, EVT	30	77	17	0	20

^aDefined as TIMI or TICI grade ≥ 2a, final revascularization rate including rescue therapies;

^bAssessed at 90 d unless otherwise specified;

^cDefined as mRS ≤ 2 unless otherwise specified;

^dThis study used mRS ≤ 1 as the primary clinical efficacy endpoint and assessed mortality at day 7 ± 2;

^eReported as 65%, 81%, 70% and 77% for ICA, M1, single M2 and multiple M2 occlusions, respectively; statistically significant (P < 0.05); SWIFT: SOLITAIRE™ with the intention for thrombectomy; TREVO 2: Thrombectomy REvascularization of Large Vessel Occlusions in Acute Ischemic Stroke; AIS: Acute ischemic stroke; IMS: Interventional Management of Stroke; IVT: Intravenous thrombolysis; ICH: Intracerebral hemorrhage; TIMI: Thrombolysis in Myocardial Infarction; TICI: Thrombolysis in Cerebral Ischemia; mRS: Modified Rankin Score.