Mechanical Thrombectomy using Distal Access Catheters: Current Status and Future Prospects.

Area of Science:

• Endovascular neurosurgery
• Cerebrovascular diseases
• Interventional neurology

Background:

• Mechanical thrombectomy (MT) is effective for restoring intracranial circulation and reducing procedure times.
• Modern devices have significantly improved outcomes in stroke treatment.
• Endovascular techniques are crucial for managing acute ischemic stroke.

Purpose of the Study:

• To outline endovascular techniques using distal access catheters.
• To describe the applicability and outcomes of these techniques.
• To share experience from over 700 procedures in a hyperacute stroke center.

Main Methods:

• Review of endovascular techniques employing distal access catheters.
• Procedures performed with or without stent retrievers.
• Experience gained from a 10-year, 24/7 hyperacute stroke service.

Main Results:

• Distal access catheter techniques provide rapid reperfusion with minimal complications.
• Effective for navigating tortuous intracranial and cervical vasculature.
• Successful in treating Middle Cerebral Artery, M2/M3, and basilar artery occlusions, including with suction alone.

Conclusions:

• Distal access catheter techniques, used alone or with stent retrievers, enable rapid reperfusion.
• These techniques offer a safe and effective approach to mechanical thrombectomy.
• Proven utility in complex stroke cases and challenging vascular anatomy.