A total of 20 studies involving 8,166 patients were included in the meta-analysis. Results indicated that patients treated with CA achieved significantly higher reperfusion rates, as measured by Thrombolysis in Cerebral Infarction (TICI) scores, compared to those treated with SR, especially for excellent reperfusion (TICI 3) (OR = 1.39; 95% CI: 1.01-1.91; p < 0.05; I² = 84%). The Modified TICI scores (2B-3), which indicate successful reperfusion, were also more favorable for CA, with the First Pass yielding (OR = 1.422; 95% CI: 1.007-2.007; p = 0.045; I² = 71%), while the End of Procedures demonstrated (OR = 2.18; 95% CI: 1.74-2.74; p < 0.00001; I² = 72%), indicating enhanced reperfusion throughout the procedure. No significant difference in mortality was observed (OR = 1.00; 95% CI: 0.87-1.14; p = 0.47; I² = 0%).

This meta-analysis indicates that CA provides a superior clinical response compared to SR, enhancing reperfusion without affecting 90-day mortality in patients with ischemic stroke from large vessel occlusion in the anterior circulation. Further research is needed to explore long-term implications.