Mechanical thrombectomy benefits large vessel occlusion

(HealthDay)—For patients with acute ischemic stroke caused by large artery occlusion, mechanical thrombectomy after usual care is associated with improved outcomes versus usual care alone, according to a review published in the Dec. 8 issue of the Journal of the American College of Cardiology.

Islam Y. Elgendy, M.D., from the University of Florida in Gainesville, and colleagues conducted a systematic review to examine whether mechanical thrombectomy after usual care correlates with better outcomes in patients with acute ischemic stroke caused by large artery occlusion. Data were included from nine trials, with 2,410 patients.

The researchers found that mechanical thrombectomy correlated with a higher incidence of achieving good functional outcome, defined as a modified Rankin scale (mRS) of 0 to 2, (risk ratio [RR], 1.45; 95 percent confidence interval [CI], 1.22 to 1.72) and excellent functional outcome (mRS 0 to 1; RR, 1.67; 95 percent CI, 1.27 to 2.19) at 90 days, compared with usual care (both P < 0.0001). Mechanical thrombectomy correlated with a trend toward reduced all-cause mortality (RR, 0.86; 95 percent CI, 0.72 to 1.02; P = 0.09). With either treatment modality the risk of symptomatic intracranial hemorrhage was similar (RR 1.06; 95 percent CI, 0.73 to 1.55; P = 0.76).

"Mechanical thrombectomy after usual care was associated with improved functional outcomes compared with usual care alone, and was found to be relatively safe, with no excess in intracranial hemorrhage," the authors write.

Several authors disclosed financial ties to the pharmaceutical industry.

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