The evolution of personalized stroke thrombectomy
Stroke is a leading cause of disability and death worldwide, with acute ischemic stroke accounting for most cases. Mechanical thrombectomy is a widely accepted treatment modality in appropriately selected patients, demonstrating improved functional outcomes through safe and effective recanalization....
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2025-07-01
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| Series: | Frontiers in Surgery |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fsurg.2025.1590146/full |
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| author | Emmanuel O. Mensah Yew-Weng Fong Yew-Weng Fong Sandeep Muram Christopher S. Ogilvy Philipp Taussky |
| author_facet | Emmanuel O. Mensah Yew-Weng Fong Yew-Weng Fong Sandeep Muram Christopher S. Ogilvy Philipp Taussky |
| author_sort | Emmanuel O. Mensah |
| collection | DOAJ |
| description | Stroke is a leading cause of disability and death worldwide, with acute ischemic stroke accounting for most cases. Mechanical thrombectomy is a widely accepted treatment modality in appropriately selected patients, demonstrating improved functional outcomes through safe and effective recanalization. However, traditional trials have focused on a narrow subset of patients, limiting its applicability to diverse populations who would otherwise benefit from thrombectomy. Advances in neurovascular imaging, device innovation, and procedural techniques are driving a paradigm shift toward personalized stroke thrombectomy. This review explores personalization strategies across various domains, including lesion-specific considerations such as medium vessel occlusions (MeVOs), basilar artery occlusions (BAOs), and tandem lesions, as well as patient-specific factors like infarct size, low NIHSS scores, advanced age, and unique biomarkers. Additionally, we discuss procedural innovations, such as tailored device use and alternative access strategies to address anatomical and clinical complexities. While substantial progress has been made, challenges remain in refining patient selection criteria, mitigating procedural risks, and ensuring equitable access to thrombectomy. Future directions include taking full advantage of advanced imaging modalities, incorporating biomarkers for personalized care, and optimizing thrombectomy devices to support the use of thrombectomy in underrepresented populations. Precision thrombectomy has the potential to be adapted to a broader spectrum of patients, improving outcomes and ultimately reducing the global burden of stroke. |
| format | Article |
| id | doaj-art-a6e09c8d65f24ba989f0f0a29a4c8de2 |
| institution | Kabale University |
| issn | 2296-875X |
| language | English |
| publishDate | 2025-07-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Surgery |
| spelling | doaj-art-a6e09c8d65f24ba989f0f0a29a4c8de22025-08-20T03:58:49ZengFrontiers Media S.A.Frontiers in Surgery2296-875X2025-07-011210.3389/fsurg.2025.15901461590146The evolution of personalized stroke thrombectomyEmmanuel O. Mensah0Yew-Weng Fong1Yew-Weng Fong2Sandeep Muram3Christopher S. Ogilvy4Philipp Taussky5Neurosurgical Service, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, United StatesNeurosurgical Service, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, United StatesDepartment of Neurosurgery, Cathay General Hospital, Taipei, TaiwanNeurosurgical Service, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, United StatesNeurosurgical Service, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, United StatesNeurosurgical Service, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, United StatesStroke is a leading cause of disability and death worldwide, with acute ischemic stroke accounting for most cases. Mechanical thrombectomy is a widely accepted treatment modality in appropriately selected patients, demonstrating improved functional outcomes through safe and effective recanalization. However, traditional trials have focused on a narrow subset of patients, limiting its applicability to diverse populations who would otherwise benefit from thrombectomy. Advances in neurovascular imaging, device innovation, and procedural techniques are driving a paradigm shift toward personalized stroke thrombectomy. This review explores personalization strategies across various domains, including lesion-specific considerations such as medium vessel occlusions (MeVOs), basilar artery occlusions (BAOs), and tandem lesions, as well as patient-specific factors like infarct size, low NIHSS scores, advanced age, and unique biomarkers. Additionally, we discuss procedural innovations, such as tailored device use and alternative access strategies to address anatomical and clinical complexities. While substantial progress has been made, challenges remain in refining patient selection criteria, mitigating procedural risks, and ensuring equitable access to thrombectomy. Future directions include taking full advantage of advanced imaging modalities, incorporating biomarkers for personalized care, and optimizing thrombectomy devices to support the use of thrombectomy in underrepresented populations. Precision thrombectomy has the potential to be adapted to a broader spectrum of patients, improving outcomes and ultimately reducing the global burden of stroke.https://www.frontiersin.org/articles/10.3389/fsurg.2025.1590146/fullstroke thrombectomypersonalized medicinelarge vessel occlusionendovascular treatmentmedium vessel occlusion |
| spellingShingle | Emmanuel O. Mensah Yew-Weng Fong Yew-Weng Fong Sandeep Muram Christopher S. Ogilvy Philipp Taussky The evolution of personalized stroke thrombectomy Frontiers in Surgery stroke thrombectomy personalized medicine large vessel occlusion endovascular treatment medium vessel occlusion |
| title | The evolution of personalized stroke thrombectomy |
| title_full | The evolution of personalized stroke thrombectomy |
| title_fullStr | The evolution of personalized stroke thrombectomy |
| title_full_unstemmed | The evolution of personalized stroke thrombectomy |
| title_short | The evolution of personalized stroke thrombectomy |
| title_sort | evolution of personalized stroke thrombectomy |
| topic | stroke thrombectomy personalized medicine large vessel occlusion endovascular treatment medium vessel occlusion |
| url | https://www.frontiersin.org/articles/10.3389/fsurg.2025.1590146/full |
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