History and Progression of Endovascular Recanalization for the Acute Ischemic Stroke in Japan

Percutaneous transluminal recanalization for acute large vessel occlusion stroke has been performed more than 30 years and progressing along with development of endovascular device. The treatment started with local injection of urokinese through simple microcatheter and guiding catheter system. In those days, single lumen balloon catheter was developed and it allowed us to navigate balloon catheter to the intracranial large arteries and the thrombus was crashed with balloon to reanalyze. In Japan, mechanical thrombectomy device approved in 2010 and the occlusion has been effectively reanalyzed. Furthermore, aspiration of thrombus using larger lumen catheter combination with vacuum system was introduced in 2011. Stent retriever has been available from 2014, and making the procedure more straightforward and successful. Romanized control studies proved the effects of mechanical thrombectomy and the treatment is becoming standard treatments for acute ischemic stroke.