Acute stroke: techniques and results with the Merci retriever

Acute ischemic stroke is one of the most prominent causes of death and disability in the modern world. Despite extensive research, the only Food and Drug Administration-approved pharmacologic treatment is intravenous recombinant tissue plasminogen activator (rt-PA). Although reperfusion remains the most robust predictor of clinical outcome, rt-PA has been linked to low recanalization rates in large-vessel occlusion. Endovascular techniques have been developed over past decade with several theoretic advantages over intravenous rt-PA alone, including longer treatment windows and higher recanalization rates in large-vessel occlusions. The Merci retriever thrombectomy device was approved by the Food and Drug Administration in 2004 for removing thrombus in acute ischemic stroke. In this article, we review the indications for acute stroke endovascular treatment with the Merci retriever as well as the involved techniques and the results of research studies.