Introduction
Methods
Data availability statement
Standard protocol approval, registration, and patient consent
Data sources and study selection
Data extraction
Quality and risk of bias assessments
Statistical analysis
Results
Literature search and screening
Study characteristics and risk of bias
Study | Loo et al, 2023 [27] | Lin et al, 2023 [28] | Cao et al, 2022 [29] | Chen et al, 2022 [30] | Mujanovic et al, 2022 [31] | Akbik et al, 2022 [32] | Yaghi et al, 2021 [33] | Chalos et al, 2019 [34] |
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Data source | Multicenter study | INSPIRE | DIRECT-MT study | Single-center study | BEYOND-SWIFT | STAR | ICA | MR CLEAN |
Study type | RO of prospective database | RO of prospective database | RO | PO | RO of prospective database | RO of prospective database | RO of prospective database | PO |
Start to end of recruitment period | 2015.1-2021.12 | 2016.1-2019.12 | 2018.5-2020.5 | 2015.1-2021.12 | 2015-2018 | 2015.6-2020.12 | 2015-2018 | 2014.3-2016.6 |
Sample size- direct mechanical thrombectomy vs bridging therapy | 132 vs 182 | 223 vs 212 | 146 vs 144 | 52 vs 42 | 715 vs 632 | 1275 vs 1036 | 290 vs 232 | 324 vs 1161 |
Age (years) (dMT vs BT, mean±SD or median,IQR) | 73.6 (10.9) vs 73.2 (10.3) | 76.0 (69.0–83.5) vs 75.5 (69.0–83.0) | 73.0 (65.0-76.0) vs 71.0 (66.0-75.0) | 68.0 (10.0) vs 69.0 (9.0) | 78.0 (70.0-84.0) vs 77.0 (68.0- 83.0) | 76.0 (11.0) vs 76.0 (11.0) | 77.0 (11.5) vs 77.6 (12.0) | 72.0 (63.0–80.0) vs 70.0 (59.0–79.0) |
Gender (dMT vs BT, Female) (n/N (%)) | 69/132 (52.3) vs 108/182 (59.8) | 128/333 (54.9) vs 103/211 (48.8) | 78/146 (53.4)vs 82/144 (56.9) | 23/52 (44.2) vs 17/42 (40.4) | 423/715 (59.2) vs 338/632 (53.5) | 688/1275 (54.0) vs 559/1036 (54.0) | 126/290 (43.4) vs 104/232 (44.8) | 171/324 (53.0) vs 621/1161 (54.0) |
Baseline NIHSS(dMT vs BT, mean±SD or median,IQR) | 8.5 (18.4) vs 8.1 (18.3) | 17.0 (12.0–21.0) vs 18.0 (13.0–21.0) | 18.0 (14.0-23.0) vs 19.0 (14.0-23.0) | 20.0 (17.0-25.5) vs 18.5 (16.0-22.0) | 17.0 (11.0-20.0) vs 16.0 (11.0-20.0) | 16.0 (7.0) vs 16.0 (6.0) | 17.0 (11.0–22.0) vs 18.0 (13.0–23.0) | 17.0 (13.0–20.0) vs 16.0 (11.0–20.0) |
ASPECTS(dMT vs BT, median,IQR) | 9 (8-10) vs 9 (8-10) | NR | 9 (7-10) vs 9 (7-10) | NR | 9 (8-10) vs 9 (8-10) | ASPECT score >6: 86% vs 87% | 9 (7-10) vs 9 (7-10) | 9 (7–10) vs 9 (7–10) |
HTN (dMT vs BT, n/N (%)) | 102/132 (77.3) vs 147/182 (80.8) | 174/233 (74.7) vs 152/212 (71.7) | 92/146 (63.0) vs 97/144 (67.4) | 30/52 (57.7) vs 21/42 (50.0) | 548/715 (77.0) vs 441/632 (70.2) | 1070/1275 (84.0) vs 840/1036 (81.0) | 236/288 (81.9) vs 186/232 (80.2) | 180/321 (56.0) vs 562/1145 (49.0) |
DM (dMT vs BT, n/N (%)) | 38/132 (24.2) vs 44/182 (28.8) | 56/233 (24.0) vs 38/210 (18.1) | 32/146 (21.9) vs 29/144 (20.1) | 11/52 (21.2) vs 11/42 (26.2) | 154/715 (21.7) vs 131/632 (20.9) | 389/1273 (31.0) vs 293/1029 (29.0) | 80/287 (27.9) vs 55/231 (23.8) | 56/321 (17.0) vs 197/1155 (17.0) |
Dyslipidemia (dMT vs BT, n/N (%)) | 50/132 (37.9) vs 81/182 (44.5) | 70/217 (32.3) vs 55/196 (28.1) | NR | NR | 330/715 (46.6) vs 288/632 (46.1) | 633/1273 (50.0) vs 442/1034 (43.0) | 156/288 (54.2) vs 106/232 (45.7) | NR |
Prior stroke (dMT vs BT, n/N (%)) | 33/132 (25.0) vs 14/182 (7.7) | 35/207 (16.9) vs 43/201 (21.4) | 24/146 (16.4) vs 24/144 (16.7) | 7/52 (13.5) vs 5/42 (11.9) | 118/715 (19.3) vs 56/632 (11.2) | 246/1083 (23.0) vs 123/818 (15.0) | 83/288 (28.8) vs 54/232 (23.3) | 83/322 (26.0) vs 164/1154 (14.0) |
Prior CVD (dMT vs BT, n/N (%)) | 28/132 (21.2) vs 38/182 (20.9) | NR | NR | 10/52 (19.2) vs 6/42 (14.3) | NR | NR | 95/289 (32.9) vs 60/231 (26.0) | 36/318 (11) vs 99/1139 (8.7) |
Smoking (dMT vs BT, n/N (%)) | 16/132 (12.1) vs 16/182 (8.8) | 35/207 (16.9) vs 43/201 (21.4) | NR | 6/52 (11.5) vs 6/42 (14.3) | 112/715 (16.2) vs 111/632 (18.5) | NR | 31/250 (12.4) vs 29/207 (14.0) | NR |
Alteplase dose | 0.9mg/kg | NR | 0.9mg/kg | 0.9mg/kg | NR | 0.9mg/kg | NR | 0.9mg/kg |
Time from onset to admission(dMT vs BT) | 0-6 vs 0-4.5 h | NR | 167 (125-206) vs 177 (126-215) min | 0-4.5 vs 0-4.5 h | NR | NR | NR | NR |
Time from onset to puncture(dMT vs BT, median,IQR or mean±SD) | 210 (160–274) vs 195 (158–250) min | 4.70 (3.42–6.76) vs 4.70 (3.42–6.76) h | 218 (170–254) vs 197 (169–268) min | 210±78 vs 218±76 min | NR | 51 (41) vs 48 (39) min | NR | 47 (31–69) vs 47 (30–71) min |
Time from puncture to reperfusion (dMT vs BT, median, IQR or mean±SD) | 36 (20–60) vs 38 (20–62) min | NR | 31 (20-45) vs 36 (20-50.5) min | (70±37) vs (78±38) min | NR | 4.3(3.0) vs 7.7 (7.0) h | NR | 215 (158–294) vs 206 (160–260) min |
End-point | ①, ②, ③, ④ | ①, ②, ③, ④ | ①, ②, ③, ④ | ①, ②, ③, ④ | ①, ③, ④ | ①, ②, ③, ④ | ②, ④ | ①, ②, ③, ④ |