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Neurothrombectomy Devices for Treatment of Acute Ischemic Stroke [Internet].


Rockville (MD): Agency for Healthcare Research and Quality; 2011 Jan. Report No.: 11-EHC020-EF.
AHRQ Comparative Effectiveness Technical Briefs.


Acute ischemic strokes are associated with poor outcomes and high healthcare burden. In patients with occlusions of large cerebral vessels, patients with high baseline stroke severity scores as defined by the National Institute of Health Stroke Score (NIHSS), and patients unlikely to benefit or having failed treatment with intravenous (IV) recombinant tissue plasminogen activator (rtPA), there is a need for alternative methods of revascularization which can improve outcomes without increasing the risk for intracranial hemorrhage. The uses of various neurothrombectomy devices (clot retrievers, aspiration/suction devices, snare-like devices, ultrasonography technologies, and lasers) have been examined in these populations. Currently, two neurothrombectomy devices are FDA-cleared through the FDA 510(k) process: the MERCI clot retriever and the Penumbra System. Various ongoing clinical trials are currently evaluating the impact of these devices, as well as other (off-label) neurothrombectomy devices, for the treatment of acute ischemic stroke. The goal of this technical brief is to describe neurothrombectomy devices currently being used or actively investigated in the treatment of patients with acute ischemic stroke and to summarize the evidence supporting their use.

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