Hong Jiankun, Chen Jianping, Gu Wei, Ming Min, Luo Jianghong, Huang Ying, Zou Qinwei
First Clinical College of Gannan Medical University, Ganzhou, Jiangxi, China.
Ganzhou People's Hospital, Ganzhou, Jiangxi, China.
Wideochir Inne Tech Maloinwazyjne. 2022 Dec;17(4):579-590. doi: 10.5114/wiitm.2022.118196. Epub 2022 Jul 17.
Although aspiration thrombectomy has shown comparable safety and efficacy to stent retriever thrombectomy for acute ischaemic stroke (AIS), the use of aspiration thrombectomy as first-line endovascular treatment for AIS remains controversial.
To perform a systematic evaluation of the safety and efficacy of aspiration thrombectomy versus stent retriever thrombectomy in the treatment of AIS.
We searched the online databases PubMed, Embase, Cochrane Library, and SinoMed to collect randomized controlled trials and retrospective studies concerning the treatment of AIS with aspiration thrombectomy and stent retriever thrombectomy. Primary outcomes included 90-day all-cause mortality, a 90-day mRS scores of 0-2, intracranial haemorrhage, and successful recanalization rate. The Jadad scale and the MINORS evaluation items were used to evaluate study quality, and RevMan 5.2 was used to conduct a meta-analysis. Any differential effects in rates between the two strategies were assessed using a random effect model.
A total of 15 articles were found, including 2 randomized controlled trials and 13 retrospective studies. It showed that aspiration thrombectomy and stent retriever thrombectomy had similar results in terms of 90-day all-cause mortality (p = 0.88), 90-day mRS scores 0-2 (p = 0.29), and intracranial haemorrhage (p = 0.47). And in terms of successful recanalization rates, the aspiration thrombectomy group had better outcomes than the stent retriever thrombectomy group (p = 0.0003). The heterogeneity of 90-day all-cause mortality (I = 0%), 90-day mRS scores of 0-2 (I = 6%), intracranial haemorrhage (I = 21%), and successful recanalization rate (I = 0%) were less than 30%.
Both aspiration thrombectomy and stent thrombectomy can be used as the first line of intravascular treatment for AIS.
尽管对于急性缺血性卒中（AIS），抽吸血栓切除术已显示出与支架取栓术相当的安全性和有效性，但将抽吸血栓切除术作为AIS的一线血管内治疗方法仍存在争议。
对抽吸血栓切除术与支架取栓术治疗AIS的安全性和有效性进行系统评价。
检索在线数据库PubMed、Embase、Cochrane图书馆和中国生物医学文献数据库，收集关于抽吸血栓切除术和支架取栓术治疗AIS的随机对照试验和回顾性研究。主要结局包括90天全因死亡率、90天改良Rankin量表（mRS）评分为0 - 2、颅内出血和成功再通率。采用Jadad量表和MINORS评价项目评估研究质量，并用RevMan 5.2进行荟萃分析。使用随机效应模型评估两种策略之间率的任何差异效应。
共找到15篇文章，包括2项随机对照试验和13项回顾性研究。结果显示，在90天全因死亡率（p = 0.88）、90天mRS评分为0 - 2（p = 0.29）和颅内出血（p = 0.47）方面，抽吸血栓切除术和支架取栓术结果相似。在成功再通率方面，抽吸血栓切除术组的结局优于支架取栓术组（p = 0.0003）。90天全因死亡率（I² = 0%）、90天mRS评分为0 - 2（I² = 6%）、颅内出血（I² = 21%）和成功再通率（I² = 0%）的异质性均小于30%。
抽吸血栓切除术和支架取栓术均可作为AIS血管内治疗的一线方法。
