A Look Back on the History of Cerebral Revascularization for Acute Ischemic Stroke: A Neurosurgeon's Perspective.

This review looks back on our experience with acute middle cerebral artery embolectomies in the 1990s, frowned upon by stroke experts at the time, and no match for the newly introduced and proven treatment of acute ischemic stroke with intravenous recombinant tissue plasminogen activator (alteplase). The past several decades have seen dramatic developments in acute cerebral revascularization, the major paradigm shift being in the form of endovascular thrombectomy. Mechanical thrombectomy has moved from the operating room, where we performed it, to the interventional angiography suite armed with ever-improving clot aspiration and retrieval technologies.