Abstract Details

Title Safety and Efficacy Outcomes of Catheter-assisted Mechanical Thrombectomy Versus Catheter-assisted Aspiration Thrombectomy in Patients with Acute MCA Occlusion Stroke: A Systematic Review and Meta-analysis

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) P6 - Poster Session 6 (5:00 PM-6:00 PM)

Poster/Presentation
Number 4-017

Objective To compare the safety and efficacy of catheter-assisted mechanical thrombectomy (using stent retrievers) versus catheter-assisted aspiration thrombectomy in patients with acute middle cerebral artery (MCA) occlusion stroke, focusing on functional recovery, mortality, and procedural efficiency.

Background Acute ischemic stroke due to MCA occlusion is a leading cause of mortality and disability. Endovascular thrombectomy is the standard for large vessel occlusions. This systematic review and meta-analysis evaluates outcomes of catheter-assisted mechanical thrombectomy (stent retrievers, SR) versus catheter-assisted aspiration thrombectomy (CAT).

Design/Methods Following PRISMA and Cochrane guidelines, we searched PubMed, Scopus, EMBASE, and Google Scholar up to July 2025. Included studies were randomized controlled trials (RCTs) and cohort studies. Continuous outcomes were analyzed using mean difference (MD) or standardized mean difference (SMD), and categorical outcomes used odds ratios (OR) with 95% confidence intervals (CIs). Heterogeneity was assessed with I² and Chi-square tests.

Results Eight studies (four retrospective cohorts, three prospective cohorts, one RCT) were included. No significant differences were observed between CAT and SR in 90-day functional independence (RR = 1.14, 95% CI = 0.93–1.39) or mortality (RR = 0.97, 95% CI = 0.72–1.31). Symptomatic intracranial hemorrhage rates were comparable, with CAT showing a nonsignificant trend toward lower risk. CAT achieved faster recanalization (MD = –38 min, p = 0.0008) and shorter procedure times (MD = –27 min, p = 0.028), despite heterogeneity. First-pass effect, NIHSS improvement, onset-to-groin puncture time, and rescue therapy requirements showed no significant differences.

Conclusions CAT offers procedural advantages with faster recanalization and shorter procedure times compared to SR, without compromising functional recovery, mortality, or safety outcomes. Further trials are needed to strengthen evidence for specific population subgroups.

Authors/Disclosures
Hafiz Sohail Ashraf, MD PRESENTER	Dr. Ashraf has nothing to disclose.
Rida Shakeel, MBBS	Dr. Shakeel has nothing to disclose.
ZAIN U. ABEDIN, MBBS	Mr. ABEDIN has nothing to disclose.
Javed Iqbal, PhD	Mr. Iqbal has nothing to disclose.
Faizan Mazhar, PhD	Dr. Mazhar has nothing to disclose.
Raghabendra kumar Mahato, Medical Student	Mr. Mahato has nothing to disclose.
Rabia Asim, MBBS	Miss Asim has nothing to disclose.
Anas Mansour, MD	Dr. Mansour has nothing to disclose.
Abdullah Khan, MBBS	Dr. Khan has nothing to disclose.
Huzaifa S. Nawaz, MBBS	Dr. Nawaz has nothing to disclose.
Sohaib Aftab Ahmad Chaudhry, MBBS	Dr. Chaudhry has nothing to disclose.

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