Mechanical thrombectomy devices for treatment of stroke

Mechanical thrombectomy devices comprise a wide array of endovascular tools cleared for removing thrombi from the neurovasculature in acute ischemic stroke patients. In the United States, 3 classes of mechanical thrombectomy devices have been cleared by the Food and Drug Administration: coil retrievers in 2004, aspiration devices in 2008, and stent retrievers in 2012. Available evidence and fundamental physiologic principles suggest that mechanical thrombectomy is appropriate for patients with large, proximal intracranial artery occlusions due to emboli of cardiac or arterial origin and is most effective when performed as soon as feasible after onset in patients known to still be harboring salvageable penumbral tissue. This review summarizes the mechanism of action of these devices, clinical trial results for efficacy and safety, and clinical use.