{
  "abstract": "Background For large vessel occlusion (LVO) ischemic strokes, three major techniques of mechanical thrombectomy (MT) have demonstrated efficacy. Here we compare the safety and efficacy of stent retrievers (SR), contact aspiration (Asp), and a combined mechanical thrombectomy (cMT) for LVO ischemic stroke.Methods Using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we queried the PubMed, EMBASE, Scopus, and Web of Science databases for studies published prior to December 2024 describing patients with ischemic stroke who underwent MT using SR, Asp, or cMT.Results Twnety-four studies comprising a total of 12 845 patients were included in the analysis. Compared with cMT, Asp was associated with a lower rate of first pass effect (FPE) (risk ratio (RR) 0.67; 95% CI 0.46 to 0.96), shorter procedure duration (mean difference (MD) −13.35 min; 95% CI −20.83 to –5.87), and lower risk of arterial dissection (RR 0.50; 95% CI 0.29 to 0.87). Additionally, SR use was linked to a higher procedure duration compared with Asp (MD 13.39 min; 95% CI 5.55 to 21.22) and a lower symptomatic intracranial hemorrhage rate (RR 0.75; 95% CI 0.59 to 0.96). No significant differences were observed between groups in terms of number of passes, successful recanalization, 90-day functional outcomes, mortality, arterial perforation, or embolization to new territory.Conclusions All three techniques demonstrated similar recanalization rates and functional outcomes. However, Asp was associated with shorter procedure times and fewer arterial dissection complications, while cMT showed a higher FPE. Given the comparable overall efficacy, the choice of technique should be guided by the physician’s preference, expertise, and confidence, tailored to the individual patient’s profile.",
  "authors": [
    {
      "affiliations": [
        "Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota, USA"
      ],
      "name": "Abdelrahman M Hamouda"
    },
    {
      "affiliations": [
        "University of South Dakota Sanford School of Medicine, Sioux Falls, South Dakota, USA"
      ],
      "name": "Nicholas Kendall"
    },
    {
      "affiliations": [
        "Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota, USA"
      ],
      "name": "Zach Pennington"
    },
    {
      "affiliations": [
        "Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota, USA"
      ],
      "name": "Rahul Kumar"
    },
    {
      "affiliations": [
        "Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota, USA"
      ],
      "name": "Mohamed M Elgohary"
    },
    {
      "affiliations": [
        "Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota, USA"
      ],
      "name": "Seth Ransom"
    },
    {
      "affiliations": [
        "Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota, USA"
      ],
      "name": "Julian Rechberger"
    },
    {
      "affiliations": [
        "Faculty of Medicine, 6th October University, Cairo, Egypt"
      ],
      "name": "Nada S Ahmed"
    },
    {
      "affiliations": [
        "Department of Neurosurgery, Mayo Clinic, Rochester, Minnesota, USA"
      ],
      "name": "Stanley Dennison"
    },
    {
      "affiliations": [
        "Alexandria University Faculty of Medicine, Alexandria, Egypt"
      ],
      "name": "Elsayed M Hammad"
    },
    {
      "affiliations": [
        "Department of Neurosurgery, Mayo Clinic, Rochester, Minnesota, USA"
      ],
      "name": "Basant Lashin"
    },
    {
      "affiliations": [
        "Department of Radiology, Mayo Clinic, Rochester, Minnesota, USA"
      ],
      "name": "Abdullah Reda"
    },
    {
      "affiliations": [
        "Department of Radiology, Mayo Clinic, Rochester, Minnesota, USA"
      ],
      "name": "Sherief Ghozy"
    },
    {
      "affiliations": [
        "Department of Neurology, Mayo Clinic, Rochester, Minnesota, USA"
      ],
      "name": "Kogulavadanan Arumaithurai"
    },
    {
      "affiliations": [
        "Department of Radiology, Mayo Clinic, Rochester, Minnesota, USA"
      ],
      "name": "Ram Kadirvel"
    },
    {
      "affiliations": [
        "Department of Radiology, Mayo Clinic, Rochester, Minnesota, USA"
      ],
      "name": "Waleed Brinjikji"
    },
    {
      "affiliations": [
        "Department of Radiology, Mayo Clinic, Rochester, Minnesota, USA"
      ],
      "name": "David F Kallmes"
    }
  ],
  "title": "Outcomes of combined mechanical thrombectomy versus stent retriever or contact aspiration in acute ischemic stroke: an updated network meta-analysis",
  "uid": "4ba0f77f-da81-5634-9ea0-7c5b7ef13bf6"
}