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American Heart Association

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Final ID: TMP82

First line aspiration versus stent retriever for posterior circulation stroke; A meta-analysis

Abstract Body: Introduction
Aspiration and stent retriever thrombectomy are the primary approaches for endovascular management of posterior circulation stroke. However, the optimal first-line choice of surgical technique remains unclear. This study aims to conduct a systematic review and meta-analysis comparing first-line aspiration with stent retriever thrombectomy in terms of recanalization rates, complications, and clinical outcomes.
Methodology
This systematic review and meta-analysis followed PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Databases searched included PubMed, Embase, Web of Science, Cochrane, and ClinicalTrials.gov, focusing on studies comparing the efficacy and safety of first-line aspiration versus stent retriever thrombectomy for posterior circulation stroke. Data analysis was performed using RevMan version 5.4.1, with statistical significance set at p < 0.05.
Result
A total of 21 studies, including 2,521 patients, were analyzed. First-line aspiration demonstrated a significant advantage in terms of successful recanalization (OR = 1.36; 95% CI: 1.04–1.76; p = 0.002) and complete recanalization (OR = 1.41; 95% CI: 0.91–2.20; p = 0.03), both favoring aspiration over the stent retriever technique. Additionally, first-line aspiration was associated with a significantly lower overall complication rate (OR = 0.58; 95% CI: 0.40–0.85; p = 0.005) and a shorter procedural time (SMD = -0.60; 95% CI: -0.81 to -0.40; p < 0.005). However, there were no statistically significant differences between the two techniques in the first pass effect (OR = 1.41; 95% CI: 0.95–2.09; p = 0.09), the need for rescue therapy (OR = 1.01; 95% CI: 0.71–1.44; p = 0.96), 90-day all-cause mortality (OR = 0.95; 95% CI: 0.71–1.27; p = 0.72), and 90-day favorable functional outcome (OR = 1.17; 95% CI: 0.97–1.41; p = 0.11).
Conclusion
This meta-analysis suggests that first-line aspiration may offer advantages over stent retrievers for posterior circulation stroke, particularly in terms of recanalization success and procedural safety. However, no significant differences were observed in key clinical outcomes such as mortality and favorable recovery.
  • Thapa, Sangharsha  ( Westchester Medical Center , White Plains , New York , United States )
  • Chong, Ji  ( Westchester Medical Center , Valhalla , New York , United States )
  • Santarelli, Justin  ( Westchester Medical Center , Valhalla , New York , United States )
  • Al-mufti, Fawaz  ( Westchester Medical Center , Valhalla , New York , United States )
  • Gandhi, Chirag  ( WESTCHESTER MEDICAL CENTER , Valhalla , New York , United States )
  • Kaur, Gurmeen  ( Westchester Medical Center , Stamford , Connecticut , United States )
  • Author Disclosures:
    Sangharsha Thapa: DO NOT have relevant financial relationships | Ji Chong: No Answer | Justin Santarelli: DO NOT have relevant financial relationships | Fawaz Al-Mufti: No Answer | Chirag Gandhi: No Answer | Gurmeen Kaur: DO NOT have relevant financial relationships
Meeting Info:
Session Info:

Neuroendovascular Moderated Poster Tour II

Thursday, 02/06/2025 , 06:00PM - 07:00PM

Moderated Poster Abstract Session

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