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Optimized Management of Endovascular Treatment for Acute Ischemic Stroke
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First-line contact aspiration versus first-line stent retriever for acute ischemic stroke with M2 occlusion: A

Xuebin Wen1, Gengfan Ye2, Zhenqiang Li2

  • 1Department of Anesthesiology, Ningbo Medical Center Lihuili Hospital, Ningbo 315040, Zhejiang, China.

Clinical Neurology and Neurosurgery
|March 29, 2022
PubMed
Abstract

Insights

For acute ischemic stroke in the middle cerebral artery M2 segment, both contact aspiration (CA) and stent retriever (SR) techniques show similar reperfusion rates and patient outcomes. Further randomized trials are needed to confirm these findings.

Area of Science:

  • Neurology
  • Interventional Neuroradiology
  • Stroke Medicine

Background:

  • Mechanical thrombectomy is a standard treatment for acute ischemic stroke due to middle cerebral artery M2 segment occlusion.
  • The comparative efficacy of first-line contact aspiration (CA) versus stent retriever (SR) techniques remains unclear.

Approach:

  • A systematic review and meta-analysis were conducted following PRISMA guidelines.
  • Seven observational studies were included, assessing reperfusion (mTICI 2b/3) and 90-day functional independence (mRS 0-2).
  • Meta-analysis of five studies (601 patients) used random-effects models to pool outcomes.

Key Points:

  • Six of seven studies found no significant difference in reperfusion between CA and SR.
  • All seven studies reported comparable 90-day functional independence rates for both techniques.
  • Pooled meta-analysis showed similar reperfusion (OR=1.18) and functional independence (OR=1.18) between first-line CA and SR.

Conclusions:

  • First-line CA and SR demonstrate similar efficacy for reperfusion and 90-day clinical outcomes in acute M2 occlusion stroke.
  • The choice between CA and SR as a first-line strategy may not significantly impact patient prognosis.
  • High-quality randomized controlled trials are necessary to definitively compare these endovascular techniques.
Keywords:
Acute ischemic strokeContact aspirationM2 occlusionRecanalizationStent retriever

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