%0 Journal Article
%T First
%A Benjamin Gory
%A Bertrand Lapergue
%A Emmanuel Touz谷
%A Francis Turjman
%A Marion Boulanger
%A Michel Piotin
%A Ren谷 Anxionnat
%A Serge Bracard
%J Interventional Neuroradiology
%@ 2385-2011
%D 2019
%R 10.1177/1591019918821074
%X In acute ischemic stroke patients with large-artery occlusion, uncertainties remain about whether clinically important outcomes are comparable between first-line contact aspiration and stent-retriever thrombectomy, although two trials have investigated whether one strategy should be preferred over another. The purpose of this article is to compare the efficacy and safety of first-line contact aspiration and stent-retriever thrombectomy in stroke patients with anterior circulation large-artery occlusion. We undertook a systematic review of studies of patients treated for large-artery occlusion, with the latest devices of either strategy, within six hours of stroke onset. We determined rates of final complete reperfusion (defined as modified Thrombolysis In Cerebral Infarction scoreˋ=ˋ3), periprocedural complications and 90-day functional independence (defined as modified Rankin Scale (mRS) score 0每2), and excellent outcome (defined as mRS score 0每1) after contact aspiration and after stent-retriever thrombectomy using random-effects meta-analyses. Any differential effects in rates between the two strategies were assessed using random-effects meta-regressions. Fifteen studies (1817 patients) were included. There was no difference in rates of final complete reperfusion at the end of all endovascular procedures between contact aspiration and stent retrievers (51.1%, 95% confidence interval (CI) 39.3每62.9; vs 38.3%, 95% CI 28.6每48.0; pintˋ=ˋ0.14), 90-day functional independence (45.0%, 40.7每49.2; vs 52.4%, 47.7每57.1; pintˋ=ˋ0.45) and excellent outcome (32.1%, 25.7每38.5; vs 34.1%, 21.2每46.9; pintˋ=ˋ0.94). Rates of periprocedural complications did not differ between the two strategies. Current data suggest no difference in efficacy and safety between first-line contact aspiration and stent-retriever thrombectomy in stroke patients with large-artery occlusion
%K Endovascular treatment
%K ischemic stroke
%K meta-analysis
%K thrombectomy
%U https://journals.sagepub.com/doi/full/10.1177/1591019918821074