[Mechanical recanalization in acute stroke. Torture or choice].

CLINICAL/METHODICAL ISSUE: Stroke is the third most common cause of death in the developed world and the leading cause of disability worldwide. The present demographic development will lead to increased numbers of stroke patients in the future. STANDARD RADIOLOGICAL
METHODS: Patient selection takes place by using various computer tomographic (CT) or magnetic resonance (MR) imaging modalities. For endovascular stroke treatment a modern biplane angiography suite is recommended. METHODICAL INNOVATIONS: Intra-arterial chemical thrombolysis was shown to be effective in achieving recanalization and improving clinical outcome. Mechanical devices were introduced in the late 1990s and the highly effective stent retriever was recently included. PERFORMANCE: Mechanical devices allows a recanalization rate of up to 90 % of affected brain vessels. ACHIEVEMENTS: The advantage of a stent retriever compared to other mechanical devices seems to be an improvement in good clinical outcome. PRACTICAL RECOMMENDATIONS: Currently, the stent retriever seems to be the definitive first choice in the use of mechanical devices for intra-arterial recanalization treatment in acute ischemic stroke.