An Official publication of The Asian Congress of Neurological Surgeons (AsianCNS)

Search Article
Home About us Editorial board Search Ahead of print Current issue Archives Submit article Instructions Advertise Subscribe Contacts Login  Facebook Tweeter
  Users Online: 361 Home Print this page Email this page Small font sizeDefault font sizeIncrease font size  
Year : 2020  |  Volume : 15  |  Issue : 2  |  Page : 251-261

Aspiration thrombectomy for posterior circulation stroke: A systematic review and meta-analysis

1 Department of Surgery, University of Sydney, Camperdown, NSW, Australia
2 Department of Surgery, Sir Charles Gairdner Hospital, Nedlands, WA, Australia

Correspondence Address:
Kevin Sheng
University of Sydney, Camperdown, NSW, 2006
Login to access the Email id

Source of Support: None, Conflict of Interest: None

DOI: 10.4103/ajns.AJNS_151_19

Rights and Permissions

Purpose: This study aims to analyze the efficacy of aspiration thrombectomy for large vessel occlusion of the posterior circulation, with an emphasis on comparison with stent retriever thrombectomy. Methods: A systematic review and meta-analysis were performed to analyze the outcomes of aspiration thrombectomy for acute posterior circulation stroke. For those studies that included data for both aspiration and stent-retriever thrombectomy, we additionally performed a second meta-analysis comparing their outcomes against each other. Results: A total of 17 articles were included. For the primary outcomes, the weighted pooled rate of mortality was 26.71% (95% confidence interval [CI] 19.35%–34.71%), modified Ranking Score (mRS) 0–2 at 3 months was 36.71 (95% CI 32.02%–41.52%), and successful recanalization 89.26% (95% CI 83.12%–94.31%). Primary stent retriever thrombectomy was inferior to primary aspiration thrombectomy for the outcomes of successful recanalization (odds ratio [OR] 0.57, 95% CI 0.36–0.91, P = 0.018), complete recanalization (OR 0.65, 95% CI 0.42–0.1.00, P = 0.048), procedure time (mean difference 28.17, 95% CI 9.47–46.87), and rate of embolization to new territory (OR 5.01, 95% CI 1.20–20.87, P = 0.027). No significant difference was seen for other outcomes. Further subgroup analysis suggests that for the outcome of recanalization, this may be dependent on the availability of second-line stent retriever thrombectomy. Limitations: The included studies were observational in nature. There was unresolved heterogeneity in some of the outcomes. Conclusions: There was no statistically significant difference seen for the primary outcomes of mortality and favorable outcome (mRS score 0–2) at 3 months. While superior rates of successful recanalization, complete recanalization, faster procedural time, and improved safety profile for primary aspiration thrombectomy were seen compared to primary stent retriever thrombectomy, this did not translate into superior clinical outcomes.

Print this article     Email this article
 Next article
 Previous article
 Table of Contents

 Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
 Citation Manager
 Access Statistics
 Reader Comments
 Email Alert *
 Add to My List *
 * Requires registration (Free)

 Article Access Statistics
    PDF Downloaded245    
    Comments [Add]    

Recommend this journal