Direct aspiration versus stent retriever as First-line thrombectomy techniques for acute Basilar artery occlusions: an updated systematic review and Meta-Analysis.

Background: Endovascular thrombectomy is the primary treatment for acute basilar artery occlusion (BAO), with direct aspiration (DA) and stent retriever (SR) as the main techniques. This updated meta-analysis aims to compare these two techniques in terms of efficacy and safety outcomes. Methods: A s...

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Publicado en:Neuroradiology Vol. 67; no. 10; pp. 2851 - 2868
Autores principales: Lee, Wei Jun, Correia Maciel, Rafaela, Abo Kasem, Rahim, Najdawi, Zaid, Elfil, Mohamed, Khasawneh, Mohammad, Leite, Marianna, Barbosa Pereira da Silva, Davi, dos Reis Schevz, Rodrigo, Quaresma Sardella, Gabriela, Toth, Gabor, Al-Mufti, Fawaz
Formato: meta analysis research systematic review tables/charts Journal Article
Publicado: Springer Nature Oct2025
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Oct2025
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      pub: Springer Nature
      place: New York, New York
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        10.1007/s00234-025-03749-0
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        atl: Direct aspiration versus stent retriever as First-line thrombectomy techniques for acute Basilar artery occlusions: an updated systematic review and Meta-Analysis.
      aug:
        au:
          Lee, Wei Jun
          Correia Maciel, Rafaela
          Abo Kasem, Rahim
          Najdawi, Zaid
          Elfil, Mohamed
          Khasawneh, Mohammad
          Leite, Marianna
          Barbosa Pereira da Silva, Davi
          dos Reis Schevz, Rodrigo
          Quaresma Sardella, Gabriela
          Toth, Gabor
          Al-Mufti, Fawaz
        affil: https://ror.org/0041qmd21 SUNY Downstate Medical Center, Brooklyn, United States
      sug:
        subj:
          Basilar Artery Pathology
          Arterial Occlusive Diseases Surgery
          Aspiration
          Stents
          Thrombectomy Methods
          Patient Safety
          Treatment Outcomes
          Human
          Systematic Review
          Meta Analysis
          PubMed
          Embase
          Cochrane Library
          Intracranial Hemorrhage
          Confidence Intervals
          Odds Ratio
          Descriptive Statistics
          Probability
          Hypertension
          Diabetes Mellitus
          Hyperlipidemia
      ab: Background: Endovascular thrombectomy is the primary treatment for acute basilar artery occlusion (BAO), with direct aspiration (DA) and stent retriever (SR) as the main techniques. This updated meta-analysis aims to compare these two techniques in terms of efficacy and safety outcomes. Methods: A search was performed across PubMed, Embase, and Cochrane databases on December 23, 2024. Primary outcomes included good and favorable functional outcomes. Secondary outcomes included procedural outcomes, such as successful and complete recanalization, and safety outcomes, including symptomatic intracranial hemorrhage and mortality at 90 days. Leave-one-out sensitivity analysis was used to assess each study's influence on the pooled effect by systematically excluding one study at each time. Results: Out of 4,424 studies initially screened, a total of 14 studies with 1,851 patients were ultimately included (DA = 830, SR = 1,021). There were no significant differences in favorable and good functional outcomes (OR 1.07; 95% CI 0.82–1.39; P = 0.626; OR 1.19; 95% CI 0.94–1.50; P = 0.152, respectively) nor mortality (OR 0.83; 95% CI 0.63–1.09; P = 0.177). A significant difference was observed in complete recanalization rates in sensitivity analyses, favoring DA, which was not evident in the successful recanalization rates. The DA group also demonstrated a lower risk of sICH (OR 0.56; 95% CI 0.34–0.93; P = 0.025). Conclusion: Our meta-analysis shows that DA and SR techniques for BAO thrombectomy each have distinct procedural trade-offs. Due to data heterogeneity and observational design, neither method can be definitively recommended. Treatment decisions should be individualized until high-quality randomized data are available.
      pubtype: Academic Journal
      doctype:
        meta analysis
        research
        systematic review
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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