What type of study is this?

This is a Systematic Review study.

December 6, 2025Open Access

Abstract 217: Outcomes of Combined Mechanical Thrombectomy Versus Stent Retriever or Contact Aspiration in Acute Ischemic Stroke: An Updated Network Meta‐Analysis

Key Points

Combined mechanical thrombectomy demonstrated a higher risk of arterial dissection, with a risk ratio of 2.00.
The analysis included 12,845 patients across 24 studies, showing comparable outcomes across techniques.
Systematic review and meta-analysis of mechanical thrombectomy approaches, adhering to PRISMA guidelines.
Results highlight that technique choice should be based on individual patient profiles and physician confidence.

Abstract

Introduction For large vessel occlusion (LVO) ischemic strokes, three major techniques of mechanical thrombectomy have demonstrated efficacy. In this study, we compared stent retrievers (SR),contact aspiration (Asp), and a combined approach to provide an updated comparison of key outcomes for each strategy. Methods We followed PRISMA guidelines to conduct a systematic review and meta‐analysis across PubMed, EMBASE, Scopus, and Web of Science databases up to September 2024. Studies were included if they included outcomes for patients with ischemic stroke who underwent mechanical thrombectomy using a stent retriever, contact aspiration, or a combination of both techniques. Results Twenty‐four studies comprising a total of 12,845 patients were included in the analysis. Compared to the Asp technique alone, the combined mechanical thrombectomy (MT) approach was associated with a higher risk of arterial dissection (RR: 2.00; 95% CI 1.15, 3.44), longer procedure duration (MD: 13.35 minutes; 95% CI 5.87, 20.83) and associated with a lower risk of arterial dissection (RR: 0.50; 95% CI 0.29, 0.87). However, Asp was associated with a lower rate of first‐pass effect (FPE) compared to combined MT (RR: 0.67; 95% CI 0.46, 0.96). Additionally, stent retriever (SR) use was linked to a higher procedure duration compared to Asp(MD: 13.39 minutes; 95% CI 5.55, 21.22) and a lower FPE rate (RR: 0.75; 95% CI 0.59,0.96). No significant differences were observed between groups in terms of successful recanalization, 90‐day functional outcomes, or mortality. Conclusion In our analysis, all three techniques demonstrated similar recanalization rates and functional outcomes. However, aspiration was associated with shorter procedure times and fewer arterialdis section complications, while the combination technique showed a higher first pass effect. Given the comparable overall efficacy, the choice of technique should be guided by the physician's preference, expertise, and confidence, tailored to the individual patient's profile.

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