Devices and Techniques.

This extensive review explores the intricacies of the three principal mechanical thrombectomy techniques: the stent retriever technique, contact aspiration technique, and a combined approach, and their application in managing acute ischemic stroke. Each technique operates uniquely on the thrombus, leading to differences in their efficacy. Factors including clot size, clot stiffness, vessel tortuosity, and the angle of interaction between the aspiration catheter and the clot significantly influence these differences. Clinical trials and meta-analyses have shown the overall equivalency of these techniques for the treatments of large vessel occlusion and distal medium vessel occlusions. However, there are nuanced differences that emerge under specific clinical circumstances, highlighting the absence of a one-size-fits-all strategy in acute ischemic stroke management. We emphasize the need for future investigations to elucidate these nuances further, aiming to refine procedural strategies and individualize patient care for optimal outcomes.
Competing Interests: Naoki Kaneko has been a consultant for Encompass, TG Medical, and NV Medtech. Satoshi Tateshima has been a consultant for Cerenovus, Stryker and Rapid Medical and also receives royalties from Python Vascular. The other authors have no personal or financial interest in any of the materials or devices described in this article.
(©2023 The Japanese Society for Neuroendovascular Therapy.)