Endovascular Treatment for Ischemic Stroke

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  • YAMAMOTO MUNETAKA
    Department of Neurosurgery, Juntendo University Faculty of Medicine
  • OISHI HIDENORI
    Department of Neurosurgery, Juntendo University Faculty of Medicine
  • ARAI HAJIME
    Department of Neurosurgery, Juntendo University Faculty of Medicine

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In Japan, out of the total number of deaths classified by cause in 2013, 120,000 deaths were due to strokes, making up 9.3% of the total and putting stroke in 4th position. On the other hand, strokes are the number one cause that requires long-term nursing care and comprise 20% of the total. Strokes are broadly classified into cerebral infarctions, intracerebral hemorrhages, and subarachnoid hemorrhages. A cerebral infarction is caused by the occlusion of a blood vessel in the brain. The most important form of treatment for cerebral infarction is prevention. The purpose of performing recanalization therapy for acute ischemic stroke, in which the occluded vessel has reopened, is minimizing the extent of possible cerebral infarction. Intravenous administration of thrombolytic drugs to treat acute ischemic stroke within three hours of onset started being performed in Japan in 2005. In 2010, a spiral-shaped device, Merci Retrieval System, became available for use in Japan for thrombi retrieval and heralded the era of mechanical thrombectomy. In 2011, a thrombus aspiration device that used a catheter, Penumbra System, was introduced. In 2014, stent thrombectomy devices, Solitaire Flow Restoration device and Trevo ProVue Retriever, were successively introduced, which allowed for a full range of treatment selections for full-scale endovascular treatment for acute ischemic stroke.

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