D A Schartz1, N R Ellens2, G S Kohli2, S M K Akkipeddi2, G P Colby3, T Bhalla2, T K Mattingly2, M T Bender4. 1. From the Departments of Imaging Sciences (D.A.S.). 2. Neurosurgery (N.R.E., G.S.K., S.M.K.A., T.B., T.K.M., M.T.B.), University of Rochester Medical Center, Rochester, New York. 3. Department of Neurological Surgery (G.P.C.), University of California Los Angeles, Los Angeles, California. 4. Neurosurgery (N.R.E., G.S.K., S.M.K.A., T.B., T.K.M., M.T.B.), University of Rochester Medical Center, Rochester, New York matthew_bender@urmc.rochester.edu.
Abstract
BACKGROUND: The efficacy of combined aspiration catheter and stent retriever compared with stent retriever alone for the treatment of large-vessel occlusion acute ischemic stroke is unclear. PURPOSE: Our aim was to conduct a systematic literature review and meta-analysis on several metrics of efficacy comparing aspiration catheter and stent retriever with stent retriever alone. DATA SOURCES: MEDLINE and the Cochrane Library Databases were searched. Randomized controlled trials and case-control and cohort studies were included. STUDY SELECTION: Ten comparative studies were included detailing a combined 1495 patients with aspiration catheter and stent retriever and 1864 with stent retrievers alone. DATA ANALYSIS: Data on first pass effect (TICI 2b/2c/3 after first pass), final successful reperfusion (modified TICI ≥2b), and 90-day functional independence (mRS ≤ 2) were collected. Meta-analysis was performed using a random-effects model. DATA SYNTHESIS: There was a pooled composite first pass effect of 40.8% (611/1495) versus 32.6% (608/1864) for aspiration catheter and stent retriever and stent retriever alone, respectively (P < .0001). Similarly, on a meta-analysis, aspiration catheter and stent retriever were associated with a higher first pass effect compared with stent retriever alone (OR = 1.63; 95% CI, 1.20-2.21; P = .002; I2 = 72%). There was no significant difference in composite rates of successful reperfusion between aspiration catheter and stent retriever (72.8%, 867/1190) and stent retriever alone (70.8%, 931/1314) (P = .27) or on meta-analysis (OR = 1.31; CI, 0.81-2.12; P = .27; I2 = 82%). No difference was found between aspiration catheter and stent retriever and stent retriever alone on 90-day functional independence (OR = 1.02; 95% CI, 0.77-1.36; P = .88; I2 = 40%). LIMITATIONS: This study is limited by high interstudy heterogeneity. CONCLUSIONS: On meta-analysis, aspiration catheter and stent retriever are associated with a superior first pass effect compared with stent retriever alone, but they are not associated with statistically different final reperfusion or functional independence.
BACKGROUND: The efficacy of combined aspiration catheter and stent retriever compared with stent retriever alone for the treatment of large-vessel occlusion acute ischemic stroke is unclear. PURPOSE: Our aim was to conduct a systematic literature review and meta-analysis on several metrics of efficacy comparing aspiration catheter and stent retriever with stent retriever alone. DATA SOURCES: MEDLINE and the Cochrane Library Databases were searched. Randomized controlled trials and case-control and cohort studies were included. STUDY SELECTION: Ten comparative studies were included detailing a combined 1495 patients with aspiration catheter and stent retriever and 1864 with stent retrievers alone. DATA ANALYSIS: Data on first pass effect (TICI 2b/2c/3 after first pass), final successful reperfusion (modified TICI ≥2b), and 90-day functional independence (mRS ≤ 2) were collected. Meta-analysis was performed using a random-effects model. DATA SYNTHESIS: There was a pooled composite first pass effect of 40.8% (611/1495) versus 32.6% (608/1864) for aspiration catheter and stent retriever and stent retriever alone, respectively (P < .0001). Similarly, on a meta-analysis, aspiration catheter and stent retriever were associated with a higher first pass effect compared with stent retriever alone (OR = 1.63; 95% CI, 1.20-2.21; P = .002; I2 = 72%). There was no significant difference in composite rates of successful reperfusion between aspiration catheter and stent retriever (72.8%, 867/1190) and stent retriever alone (70.8%, 931/1314) (P = .27) or on meta-analysis (OR = 1.31; CI, 0.81-2.12; P = .27; I2 = 82%). No difference was found between aspiration catheter and stent retriever and stent retriever alone on 90-day functional independence (OR = 1.02; 95% CI, 0.77-1.36; P = .88; I2 = 40%). LIMITATIONS: This study is limited by high interstudy heterogeneity. CONCLUSIONS: On meta-analysis, aspiration catheter and stent retriever are associated with a superior first pass effect compared with stent retriever alone, but they are not associated with statistically different final reperfusion or functional independence.
Authors: Seung Hwan Kim; Hyungon Lee; Su Bin Kim; Sung Tae Kim; Jin Wook Baek; Young Jin Heo; Hae Woong Jeong; Hye Jin Kim; Jung Hyun Park; Jung-Soo Kim; Sung-Chul Jin Journal: J Clin Neurosci Date: 2020-04-21 Impact factor: 1.961
Authors: Álvaro García-Tornel; Manuel Requena; Marta Rubiera; Marian Muchada; Jorge Pagola; David Rodriguez-Luna; Matias Deck; Jesus Juega; Noelia Rodríguez-Villatoro; Sandra Boned; Marta Olivé-Gadea; Alejandro Tomasello; David Hernández; Carlos A Molina; Marc Ribo Journal: Stroke Date: 2019-06-10 Impact factor: 7.914
Authors: Ju-Yu Chueh; Anna Luisa Kühn; Ajit S Puri; Scott D Wilson; Ajay K Wakhloo; Matthew J Gounis Journal: Stroke Date: 2013-03-14 Impact factor: 7.914