Microsurgical Embolectomy in the Current Era of Pharmacological and Mechanical (Endovascular) Thrombolysis—A Reappraisal
- 1 January 2021
- journal article
- review article
- Published by Medknow in Neurology India
- Vol. 69 (3), 567-572
- https://doi.org/10.4103/0028-3886.319226
Abstract
Introduction: Microsurgical embolectomy though is the oldest known recanalization technique is being dismissed in favor of the latest mechanical endovascular techniques for the management of acute large vessel occlusion. Aim and Objective: We aim to highlight the role of microsurgical embolectomy in the current era of pharmacological and mechanical (endovascular) thrombolysis. Methods: An outline of the microsurgical embolectomy technique is described along with its current indications, advantages, and disadvantages. Results: It carries higher complete (TICI 3) revascularization rates with lower risk of distal embolic events especially in cases with high clot burdens; but is more labor-intensive and has longer reperfusion time in comparison to endovascular methods along with the requirement of highly skilled neurovascular surgeons to perform it quickly. Conclusion: Microsurgical embolectomy is an important indispensable recanalization technique in the armamentarium of vascular neurosurgeons.Keywords
This publication has 23 references indexed in Scilit:
- Emergent surgical embolectomy for middle cerebral artery occlusion due to carotid plaque rupture followed by elective carotid endarterectomyJournal of Neurosurgery, 2014
- Surgical embolectomy for large vessel occlusion of anterior circulationBritish Journal of Neurosurgery, 2013
- Emergency embolectomy for embolic occlusion of the middle cerebral artery—review of the literature and two illustrative casesNeurosurgical Review, 2010
- Emergency embolectomy for treatment of acute middle cerebral artery occlusionJournal of Neurosurgery, 2007
- Time Is Brain—QuantifiedStroke, 2006
- Emergency embolectomy for acute occlusion of the middle cerebral arteryJournal of Neurosurgery, 1985
- Middle Cerebral Artery Embolectomy and Prolonged Widespread VasospasmStroke, 1973
- Embolectomy of Middle Cerebral ArteryJournal of Neurosurgery, 1963
- Microsurgery as an Aid to Middle Cerebral Artery EndarterectomyJournal of Neurosurgery, 1962
- Excision of Occlusive Lesions of the Middle Cerebral ArteryJournal of Neurosurgery, 1956