Li Jia, Sun Lixue, Zhenling Jia, Song Chaoyan, Shan Yuchao
Neurosurgery Third Department, Baoding No. 1 Central Hospital, Baoding City, Hebei Province, China.
Baoding Weiren Psychiatric Hospital, Baoding City, Hebei Province, China.
Medicine (Baltimore). 2025 Jan 31;104(5):e41395. doi: 10.1097/MD.0000000000041395.
Previous studies have not provided consistent findings regarding the efficacy of aspiration thrombectomy versus stent retriever thrombectomy in patients with acute internal carotid artery occlusion. This study aimed to evaluate the preferable endovascular technique (aspiration or stent retriever) and the impact of stent retriever utilization on both clinical and angiographic outcomes.
We collected potential scholarly articles from a variety of databases including the PubMed, Web of Science, Embase, Cochrane Library, ClinicalTrials.gov, and the World Health Organization, International Clinical Trials Registry Platform. The search spanned from the establishment of electronic databases up to March 2024. Additionally, gray literature was sourced from the references cited in the included literature reports. Statistical analysis of the combined data was performed using STATA version 11.0 (Stata Corporation, TX).
Our analysis comprises a total of 4 studies, involving 759 participants in total. Among these individuals diagnosed with internal carotid artery occlusion, 435 were assigned to the aspiration group, while 324 were designated to the stent retriever group. The findings indicated a significant increase in the rate of successful reperfusion in the stent retriever group compared to the aspiration group. Furthermore, it was observed that the incidence of overall complications, intracerebral hemorrhage, embolization formation, puncture to reperfusion time, and onset to reperfusion time in the stent retriever group did not significantly exceed that in the aspiration group.
In our review on intracranial internal carotid artery occlusion, stent retrievers outperformed direct aspiration in achieving successful reperfusion. However, further studies evaluating the effects of different approaches to internal carotid artery clot removal are required to confirm these results.
先前的研究对于急性颈内动脉闭塞患者采用抽吸血栓切除术与支架取栓术的疗效并未得出一致的结果。本研究旨在评估哪种血管内技术（抽吸或支架取栓）更优，以及使用支架取栓对临床和血管造影结果的影响。
我们从多个数据库收集了潜在的学术文章，包括PubMed、科学网、Embase、Cochrane图书馆、ClinicalTrials.gov以及世界卫生组织国际临床试验注册平台。检索范围涵盖电子数据库建立至2024年3月。此外，灰色文献来源于纳入文献报告中引用的参考文献。使用STATA 11.0版本（Stata公司，德克萨斯州）对合并数据进行统计分析。
我们的分析共纳入4项研究，总计759名参与者。在这些被诊断为颈内动脉闭塞的个体中，435人被分配至抽吸组，324人被分配至支架取栓组。结果表明，与抽吸组相比，支架取栓组的成功再灌注率显著提高。此外，观察到支架取栓组的总体并发症、脑出血、栓塞形成、穿刺至再灌注时间以及发病至再灌注时间的发生率并未显著超过抽吸组。
在我们对颅内颈内动脉闭塞的综述中，支架取栓在实现成功再灌注方面优于直接抽吸。然而，需要进一步研究评估不同的颈内动脉血栓清除方法的效果以证实这些结果。
