Abstract
Intravenous recombinant tissue plasminogen activator （IV rt-PA） was approved in 2005 in Japan, and it had a significant impact on acute stroke therapy. More than 50,000 patients were treated so far, but low adaptation rate of IV rt-PA was regarded as problem. Merci retriever and Penumbra system were approved in 2010 and 2011, respectively, and gradually spreading in Japan. However, the results of 3 randomized controlled trials were all negative in terms of superiority or non-inferiority of endovascular treatment compared to IV rt-PA or standard care. Next generation devices such as stent-like retrievers were shown to have better effect in clinical outcome compared to Merci retriever. It is expected that the efficacy of endovascular treatment will be confirmed by randomized controlled trials in the near future.
