Evidence map›Paper›PMID 40850763›Full record

SynthesisJournal of neurointerventional surgery2026

Evaluating the effectiveness and safety of initial thrombectomy approaches for acute anterior large vessel occlusions: a comparative network analysis of techniques.

Elvan Wiyarta, Mohammad Kurniawan, Rakhmad Hidayat, Affan Priyambodo Permana, Gideon Hot Partogi Sinaga, Refael Alfa Budiman, Gamaliel Wibowo Soetanto

Abstract readNetwork Meta-AnalysisSystematic ReviewComparative Study
In one paragraph

Synthesis in Journal of neurointerventional surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Elvan WiyartaUniversity of Indonesia Hospital, Depok, Indonesia elvan.wiyarta@ui.ac.id.ORCID http://orcid.org/0000-0002-5676-7804
Mohammad KurniawanDepartment of Neurology, Cipto Mangunkusumo National Referral Hospital, Jakarta, Indonesia.
Rakhmad HidayatDepartment of Neurology, Cipto Mangunkusumo National Referral Hospital, Jakarta, Indonesia.
Affan Priyambodo PermanaDepartment of Neurosurgery, Cipto Mangunkusumo National Referral Hospital, Jakarta, Indonesia.
Gideon Hot Partogi SinagaDepartment of Medical Science, Cipto Mangunkusumo National Referral Hospital, Jakarta, Indonesia.
Refael Alfa BudimanDepartment of Medical Science, Cipto Mangunkusumo National Referral Hospital, Jakarta, Indonesia.
Gamaliel Wibowo SoetantoDepartment of Neurointervention, Santo Borromeus Hospital, Bandung, Indonesia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAcute anterior circulation large vessel occlusion (ACLVO) strokes represent a critical challenge in stroke management. Advancements in thrombectomy strategies, including contact aspiration (CA), stent retrievers (SR), and their combination (SRA), particularly with the addition of balloon guide catheters (BGC), aim to enhance outcomes. This systematic review and Bayesian network meta-analysis evaluates the efficacy and safety of these first-line thrombectomy strategies.

methodsA systematic search was performed across nine databases up to March 15, 2025, yielding 44 studies with 19 268 participants. The risk of bias was assessed using RoB 2.0 for randomized controlled trials and ROBINS-I for observational studies. Bayesian random-effects network meta-analysis was conducted, presenting odds ratios (OR) with 95% CIs and ranking interventions via surface under the cumulative ranking curve (SUCRA). Outcomes included recanalization success (modified Thrombolysis in Cerebral Infarction (mTICI) 2b-3), first-pass effect (FPE), functional independence (modified Rankin Scale ≤2 at 90 days), symptomatic intracranial hemorrhage (sICH), and 90-day mortality.

resultsSRA+BGC was most effective for achieving mTICI 2b-3 (OR 2.87, 95% CI 1.64 to 5.20, SUCRA 90.1) and FPE (OR 7.33, 95% CI 1.71 to 39.71, SUCRA 91.0). CA+BGC yielded the highest odds of functional independence at 90 days (OR 1.96, 95% CI 1.16 to 3.41, SUCRA 88.1) and the lowest 90-day mortality (OR 0.42, 95% CI 0.20 to 0.95). Safety outcomes favored SR+BGC and SRA+BGC for reducing sICH (OR 0.59, 95% CI 0.37 to 0.91, SUCRA 85.3). CA alone was associated with significant improvements over SR in functional outcomes (OR 1.41, 95% CI 1.09 to 1.83, SUCRA 78.5), but SRA alone was linked to higher mortality (OR 1.74, 95% CI 1.06 to 2.66).

conclusionThrombectomy strategies incorporating BGC, particularly CA+BGC and SRA+BGC, achieve superior efficacy and safety outcomes in patients with acute ACLVO stroke.

Indexed as

StrokeThrombectomyHumansTreatment OutcomeCatheterStrokeThrombectomyVessel Wall

Identifiers

PMID40850763
PMCPMC13311937

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.