Kang Dong-Hun, Hwang Yang-Ha
Department of Neurosurgery, Kyungpook National University Hospital, School of Medicine, Kyungpook National University, Daegu, Korea.
Department of Radiology, Kyungpook National University Hospital, School of Medicine, Kyungpook National University, Daegu, Korea.
J Stroke. 2019 Jan;21(1):10-22. doi: 10.5853/jos.2018.03076. Epub 2019 Jan 31.
Endovascular thrombectomy (EVT) as the standard care for acute stroke due to large vessel occlusion has recently been validated through several randomized controlled trials (RCTs). Contact aspiration (CA) and stent retriever (SR) are the two major EVT methods currently used. Because the RCTs have mostly evaluated SR devices, there was a demand to test CA in relation to SR as a frontline EVT treatment method. Recently, the Contact Aspiration vs Stent Retriever for Successful Recanalization (ASTER) study, the first RCT to compare CA and SR, demonstrated similar efficacy between them as a frontline EVT for patients with large vessel occlusions. This facilitates further investigation to confirm better frontline EVT for patients with acute stroke. In this review, we discuss past and recent developments in CA techniques, focusing on related literature. Additionally, we describe practical skills to overcome technical difficulties that can be encountered during the CA procedure. Finally, we review the evolution of device technologies, including a newer version of using a large-bore aspiration catheter.
血管内血栓切除术（EVT）作为大血管闭塞所致急性卒中的标准治疗方法，最近已通过多项随机对照试验（RCT）得到验证。接触抽吸（CA）和支架取栓器（SR）是目前使用的两种主要EVT方法。由于RCT大多评估的是SR设备，因此有必要将CA与SR作为一线EVT治疗方法进行比较测试。最近，比较CA和SR的首个RCT——成功再通的接触抽吸与支架取栓器（ASTER）研究表明，对于大血管闭塞患者，二者作为一线EVT的疗效相似。这有助于进一步开展研究，以确定针对急性卒中患者更好的一线EVT方法。在本综述中，我们讨论CA技术的过去和最新进展，重点关注相关文献。此外，我们还描述了克服CA操作过程中可能遇到的技术困难的实用技巧。最后，我们回顾了设备技术的发展历程，包括使用大口径抽吸导管的新版本。
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