Mechanical thrombectomy for acute ischemic stroke: systematic review and meta-analysis

ABSTRACT

Objective

To evaluate the safety and efficacy of mechanical thrombectomy associated with standard medical treatment compared with standard medical treatment only to treat patients with acute ischemic stroke.

Methods

This was a systematic review and metaanalysis of randomized controlled trials. An electronic search was performed in the following databases: MEDLINE ^® /PubMed ^® , Cochrane Library (Trials), LILACS/IBECS (via Biblioteca Virtual em Saúde (BVS)) and Embase. Complementary searches were also conducted. The selection of studies and data collection were done by two investigators independently.

Results

The final analysis included 16 publications related to 15 studies. The mechanical thrombectomy was associated to a reduction in the risk of death of all cause (16.81% versus 20.13%; relative risk of 0.85; p=0.04), improvement in the number of patients with functional independence after 90 days (45.65% versus 27.45%; relative risk of 1.65; p<0.01), and improvement in the rate of revascularization (76.2% versus 33.85%; relative risk of 2.20; p<0.01). There was no significant difference in terms of symptomatic intracranial hemorrhage (4.78% versus 3.88%; relative risk of 1.27; p=0.21).

Conclusion

Mechanical thrombectomy associated with standard medical treatment seem to be safe and effective to treat patients with acute ischemic stroke compared with standard medical treatment only.

Thrombolytic therapy; Mechanical thrombolysis; Thrombectomy; Ischemic stroke; Systematic review