Meta-Analysis of the Efficacy and Safety of Aspiration Thrombectomy and Stent Retriever Thrombectomy in the Treatment of Acute Ischemic Stroke
LIU Anli, XUE Qian, YANG Jinshui, MIAO Ruirui, WANG Huanhuan
2025, 20(8):
992-1005.
DOI: 10.3969/j.issn.1673-5765.2025.08.008
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Objective To explore the efficacy and safety of aspiration thrombectomy and stent retriever thrombectomy in the treatment of acute ischemic stroke (AIS).
Methods Chinese and English databases, including PubMed, Cochrane Library, Embase, CNKI, Wanfang, and VIP, were searched to screen studies comparing the efficacy of aspiration thrombectomy and stent retriever thrombectomy in AIS. The efficacy indicators included 90-day mRS score, successful recanalization, and puncture-to-recanalization time. The safety indicators included hemorrhagic transformation, 90-day all-cause mortality, and other complications (vascular perforation/dissection, vasospasm, and new-onset embolism). The funnel plot was used to assess the risk of bias among the included studies. Meta-analysis was performed using RevMan 5.3 software.
Results A total of 35 studies involving 4865 patients were included. In terms of efficacy, the aspiration thrombectomy group demonstrated superior 90-day mRS scores than the stent retriever thrombectomy group (OR 1.44, 95%CI 1.03-2.00, P=0.030), higher successful recanalization rates than the stent retriever thrombectomy group (OR 1.50, 95%CI 1.18-1.92, P<0.001), and shorter puncture-to-recanalization time than the stent retriever thrombectomy group [standardized mean difference (SMD) -6.57, 95%CI -7.80--5.34, P<0.001]. In terms of safety, there were no statistically significant differences between the two techniques in hemorrhagic transformation rate (OR 0.92, 95%CI 0.76-1.12, P=0.410), 90-day all-cause mortality (OR 0.86, 95%CI 0.64-1.16, P=0.310), and the rates of other complications (OR 0.91, 95%CI 0.75-1.09, P=0.330).
Conclusions Compared with stent retriever thrombectomy, aspiration thrombectomy has similar safety for treating AIS, but has certain advantages in the successful recanalization rate and short-term prognosis, with a shorter puncture-to-recanalization time.