1. Thrombectomy with stent retriever: The stent retrieval for mechanical removal of emboli in cerebral ischemia is a design similar to a wine bottle opener, and has weak chimerism for thrombus. However, the rate of successful recanalization has improved significantly with the new generation of thrombectomy devices. Among them, the key to stent thrombectomy technology is to achieve better integration between the stent and thrombus through technical improvement and improve the rate of vascular recanalization. Push-pull release technology and positive release technology are one of the ways to achieve this. In addition, for thrombus with heavy load and its bifurcation site, double stent technology has also been proposed, but attention should be paid to possible increased damage to the vessel wall. In conclusion, the operator needs to consider how to increase the integration force between the stent and the thrombus when using stent retrieval, and pay attention to reducing the potential damage to the vessel wall.

2. Aspiration thrombectomy technique: The key to aspiration catheter thrombectomy technique is to increase the aspiration force of the aspiration catheter on the thrombus. The aspiration effect depends on the relative position of the thrombus and the aspiration force of the catheter. Theoretically, the catheter aspiration thrombectomy technique can reduce the direct cutting and pulling damage to blood vessels caused by the thrombus stent retriever, and reduce the complications of endovascular treatment. For thrombus embolism with heavy load and hard texture, direct aspiration may be more advantageous. In recent years, how to increase catheter aspiration while avoiding thrombus escape, new aspiration techniques have been emerging. For example, the double-catheter aspiration technique uses a balloon-guided catheter to close the proximal end, and then places the aspiration catheter on the proximal end of the thrombus, withdrawing while aspiration is effective. When applying aspiration techniques, it is necessary to master possible remedial techniques, such as dealing with aspiration complicated by thrombus escape. Aspiration catheters with different lumen sizes can be used for thrombus in different vascular sites, and at the same time, attention should be paid to the risk of vascular rupture and hemorrhage that may occur due to thrombus displacement. In recent years, the advantages and disadvantages of aspiration thrombectomy and stent retriever thrombectomy have become a hot topic in the field of neurointervention. Related studies have shown that there is no significant difference in functional prognosis between aspiration thrombectomy and stent thrombectomy.

3. Stent thrombectomy combined with aspiration thrombectomy: Stent thrombectomy and aspiration thrombectomy are two commonly used thrombectomy techniques, which can be used in combination to improve the efficiency of thrombus removal. Studies have shown that the successful recanalization rate of stent retriever combined with aspiration thrombectomy is higher than that of aspiration thrombectomy or stent thrombectomy alone. The stent combined aspiration thrombectomy technique can be divided into several methods according to whether the intermediate catheter touches or crosses the thrombus and the difference in negative pressure aspiration operation. Among them, the bare guide wire BWT technology can increase the aspiration force of the intermediate catheter and improve the efficiency of thrombus removal. The proximal balloon occlusion combined with thrombus aspiration technology can prevent the thrombus from escaping to other blood vessels. The SAVE technology uses stent-assisted negative pressure locking for thrombectomy. SWIM technology uses domestic intermediate catheter and thrombectomy stent. DAT technology adopts double aspiration method, and the efficiency of thrombus removal is higher. ADVANCE technology combines distal support DAC catheter and negative pressure aspiration to remove thrombus. The effect is better. The reverse half-recovery technique can reduce the thrombus debris and damage to the vessel wall. In recent years, thrombectomy technology has begun to be applied to the occlusion and recanalization of distal vessels, and it is necessary to focus on evaluating the risks and benefits of thrombectomy to avoid complications. Among them, BEMP technology is a method of stent retrieval combined with aspiration thrombectomy, which can improve the recanalization rate of distal vessel occlusion. BADDASS technology emphasizes the concept of balloon catheter, large-diameter distal access catheter, double aspiration and stent retrieval ,which has higher thrombectomy efficiency, but it is not suitable for thrombectomy through the vertebrobasilar system and radial artery approach.