Differences in effectiveness among devices for endovascular thrombectomy in patients with acute ischemic stroke
Trippoli S, Chiumente M, Messori A
Analisi statistiche e metanalisi
Journal of Stroke
In the treatment of acute ischemic stroke, the proofs of effectiveness for endovascular thrombectomy have become more robust in recent times, but some questions remain on whether the effectiveness differs across different devices (e.g. Trevo, Merci, and Solitaire). In the absence of studies that have directly compared these devices with one another, comparative information relies on the results of meta-analyses, and particularly on indirect meta-analytic comparisons conducted with a network design. The main advantages of our re-analyses of this clinical material include the evaluation of the most updated evidence on this topic and the use of a statistical technique that allows an indirect comparison between the devices. Our indirect comparisons indicate that Solitaire has a significantly better effectiveness than that of the other devices. However, owing to the well-known limitations of network meta-analyses and to the presence of heterogeneity in the overall series of 8 RCTs, our findings represent a hypothesis that needs further confirmation from other trials.
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