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Mechanical Thrombectomy for Mild Acute Ischemic Stroke with Large-Vessel Occlusion: A Systematic Review and

Xiaowen Hou1, Xu Feng1, Huixin Wang1

  • 1School of Public Health, Shenyang Medical College, Shenyang, China.

Cerebrovascular Diseases (Basel, Switzerland)
|April 4, 2022
PubMed
Abstract

Insights

Mechanical thrombectomy (MT) may not improve functional outcomes for mild acute ischemic stroke (AIS) with large-vessel occlusion (LVO). This meta-analysis found no significant association between MT and better prognosis in these patients.

Area of Science:

  • Neurology
  • Interventional Neurology
  • Stroke Medicine

Background:

  • The efficacy of mechanical thrombectomy (MT) for mild acute ischemic stroke (AIS) with large-vessel occlusion (LVO) remains debated.
  • Precise estimation of functional prognosis is crucial for treatment decisions in AIS patients.

Approach:

  • A comprehensive meta-analysis was performed, systematically searching major biomedical databases until October 2021.
  • Eleven studies comprising 1,929 patients (794 MT, 1,135 medical management) were included.
  • Pooled and subgroup analyses, sensitivity analyses, and publication bias assessments were conducted using Stata 12.0.

Key Points:

  • The meta-analysis revealed no significant association between MT and improved functional prognosis in mild AIS with LVO.
  • Excellent functional prognosis: risk ratio (RR) = 1.07 (95% CI = 0.94-1.21, p = 0.294).
  • Favorable functional prognosis: RR = 1.01 (95% CI = 0.96-1.06, p = 0.823).

Conclusions:

  • Mechanical thrombectomy may not offer a significant functional prognosis benefit for patients with mild AIS and LVO.
  • Findings suggest that current evidence does not strongly support MT for this specific patient subgroup.
  • Further research may be warranted to clarify the role of MT in mild AIS with LVO.
Keywords:
Functional prognosisLarge-vessel occlusionMechanical thrombectomyMeta-analysisMild acute ischemic stroke

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