1. Stent thrombectomy technique

2. Aspiration thrombectomy technique

According to whether the intermediate catheter touches or crosses the thrombus and the difference of negative pressure aspiration operation, the technology of stent combined aspiration thrombus removal can be divided into various methods. The early Solumbra technique (intermediate catheter assisted thrombectomy technology) was used as a remedial measure for aspiration thrombectomy. During the operation, the intermediate catheter could cross the opening of the anterior cerebral artery(ACA) and enter the middle cerebral artery without touching the thrombus. But intermediate catheter and stent retriever usually will not be withdraw at the same time. Aspiration pull-back thrombectomy technique(ARTS), when withdrawing the thrombectomy stent to the aspiration catheter, stop the withdrawal of the stent when resistance is encountered during the withdrawal process, and keep the stent and the aspiration catheter withdrawn as a whole. The characteristic of this technique is that the aspiration catheter and the stent retrieval are withdrawn at the same time. Proximal balloon occlusion combined with thrombus aspiration technique (ASAP) is to keep the intermediate catheter in place as a thrombus retrieval channel, and pull the thrombus stent retrieval directly into the intermediate catheter, which can prevent thrombus from escaping to other blood vessels, such as ACA. SAVE technology is a stent-assisted negative pressure locking technology, which is characterized in that the aspiration catheter is used to actively advance to contact the thrombus, and after the negative pressure is generated through the aspiration catheter. SAVE technology has excellent performance in both anterior circulation and posterior circulation large artery occlusion thrombectomy. DAT technology (Double Aspiration Technology), which connects the long sheath/guiding catheter and the intermediate catheter with 50ml syringes. When the stent is withdrawn, the two syringes are aspirated at the same time to maintain a negative pressure state for thrombectomy. Compared with the traditional single aspiration technology, DAT technology is more efficient for thrombectomy. ADVANCE technology pushes the distal support DAC catheter to the distal end and across the thrombectomy stent. At the same time ADVANCE technology uses a 50ml syringe for aspiration at the proximal end. When the DAC catheter crosses the end of the thrombectomy stent retrieval, withdraw the thrombectomy stent and cooperate with negative pressure aspiration at the same time. After the stent is withdrawn, continue to suck out at least 20ml of blood until there is no thrombus. If the aspiration is blocked, withdraw the DAC catheter under negative pressure. Reverse semi-recovery technology, which half withdraw the thrombectomy stent into the distal aspiration catheter (forward pushing the aspiration catheter) before thrombectomy, which has the advantages of reducing thrombus fragments and vascular wall damage.