Similarities and Differences Between Primary Percutaneous Coronary Intervention and Mechanical Thrombectomy

JACC Cardiovasc Interv. 2020 Jul 27;13(14):1683-1696. doi: 10.1016/j.jcin.2020.03.055.

Abstract

Acute ischemic stroke is among the leading causes of mortality and disability worldwide. Since 2015, as was the case for primary percutaneous coronary intervention for acute myocardial infarction, catheter-based reperfusion via mechanical thrombectomy (MT) has become the gold-standard treatment for acute ischemic stroke caused by large-vessel occlusion. Despite that, only a fraction of the world's population currently would be able to undergo MT in time, mostly because of the scarcity of 24/7 coverage by neurointerventionalists to deal with this enormous burden. Interventional cardiologists have thus been considered a logical option to aid in combating this vast demand to diminish the burden of acute ischemic stroke. However, despite some seemingly evident similarities between primary percutaneous coronary intervention and MT, for interventional cardiologists to enter this new field, they must be well trained and fully aware of all the clinical, technical, and environmental differences between these two scenarios. The main objective of this state-of-the-art paper is to serve as an introductory and comprehensive guide to familiarize the interventional cardiology community with the most critical technical aspects of MT.

Keywords: acute ischemic stroke; interventional cardiologist; large vessel occlusion; mechanical thrombectomy; primary percutaneous coronary intervention.

Publication types

  • Review

MeSH terms

  • Cardiologists
  • Clinical Competence
  • Cooperative Behavior
  • Endovascular Procedures* / adverse effects
  • Humans
  • Interdisciplinary Communication
  • Ischemic Stroke / diagnostic imaging
  • Ischemic Stroke / physiopathology
  • Ischemic Stroke / therapy*
  • Myocardial Infarction / diagnostic imaging
  • Myocardial Infarction / physiopathology
  • Myocardial Infarction / therapy*
  • Neurologists
  • Patient Care Team
  • Percutaneous Coronary Intervention* / adverse effects
  • Thrombectomy / adverse effects
  • Workflow