Mechanical thrombectomy for large-core ischemic stroke: a systematic review and meta-analysis of randomized controlled trials with trial sequential analysis

eview question / Objective The objective of this study was to compare the efficacy and safety of endovascular thrombectomy (EVT) vs Medical treatment (BMT) using a s y s t e m a t i c re v i e w a n d m e t a -a n a l y s i s o f randomized controlled trials.Condition being studied Endovascular treatment (EVT) for acute ischemic stroke (AIS) with large ischemic core infarct did not obtain routine recommendation in current clinical guidelines. METHODS Participant or population AIS patients with ASPECTS ≤5 or infarct core volume ≥50 mL receiving EVT or receiving best medical treatment (BMT).Intervention Endovascular thrombectomy (EVT) could effectively rescue at-risk brain tissue by restoring blood flow among patients with large vessel occlusion caused acute ischemic stroke (AIS), and therefore was regarded as the first-line therapeutic strategy for these patients.Comparator We conducted a systematic review and meta-analysis including all available RCTs that comparedEVT in addition to best medical treatment (BMT) versus BMT alone for large-core AIS. Study designs to be includedHence, based on the results of preceding retrospective research, six RCTs across different countries, namely, LAESTE, TENSION, TESLA, RESCUE-Japan LIMIT, SELECT2, and ANGEL-ASPECT, investigating the efficacy and safety of EVT among patients with large-core AIS were continuously designed and carried out.We conducted a systematic review and INPLASY 1 International Platform of Registered Systematic Review and Meta-analysis Protocols INPLASY Mechanical thrombectomy for large-core ischemic stroke: a systematic review and meta-analysis of randomized controlled trials with trial sequential analysis Qiu, ZM 1 ; Liu, C 2 .