Double Stent Retriever Technique for Mechanical Thrombectomy: A Systematic Review and Meta-Analysis

Area of Science:

• Neurology
• Interventional Neuroradiology
• Cardiovascular Diseases

Background:

• Acute ischemic stroke treatment is rapidly evolving, with mechanical thrombectomy as a key intervention.
• The double stent retriever technique is a novel approach for mechanical thrombectomy, but its clinical utility requires robust evaluation.
• Efficacy and safety data for the double stent retriever technique in acute ischemic stroke are limited.

Approach:

• A systematic review and meta-analysis were conducted following PRISMA 2020 guidelines.
• Searched PubMed, EMBASE, Web of Science, and Scopus for studies on double stent retriever technique in stroke.
• Included 17 studies with 128 patients, focusing on large-vessel occlusions, primarily in the anterior circulation.

Key Points:

• The double stent retriever technique was employed as a rescue strategy in 68.7% of cases and as a first-line approach in 31.3%.
• Achieved a high overall final successful recanalization rate (modified TICI ≥2b) of 92.6%.
• Demonstrated a significant first-pass effect in 76.6% of patients, with low complication rates (0.37% dissection, 1.56% subarachnoid hemorrhage).

Conclusions:

• The double stent retriever technique appears safe and effective for achieving recanalization in acute ischemic stroke.
• High rates of successful recanalization and first-pass effect suggest its potential utility.
• Limitations include the predominance of case reports/small series and the absence of a control group, necessitating prospective comparative studies.