Medical management vs mechanical thrombectomy for mild strokes


  • Mary Corcoran
  • Univadis Medical News
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A new study has found similar outcomes with best medical management (bMM) and mechanical thrombectomy (MT) for mild strokes; however, the authors caution that more research is needed. 

The study considered pooled data on 251 patients with acute ischaemic stroke with mild-deficit emergency large vessel occlusion (mELVO) who were treated with bMM or MT over a five-year period at 16 centres in Europe, Asia and North America. The researchers also conducted a meta-analysis of four studies reporting efficacy and safety outcomes with MT (n=138) or bMM (n=113) among patients with mELVO. 

In multivariable analyses, MT was associated with higher odds of asymptomatic intracranial haemorrhage (odds ratio [OR], 11.07; 95% CI 1.31-93.53; P=.03). 

The systematic review and meta-analysis, which included 843 patients, did not document any independent association between treatment groups and safety or efficacy outcomes. 

Writing in JAMA Neurology, the authors said while the multicentre study coupled with the meta-analysis suggests similar outcomes for MT and bMM in patients with stroke with mELVO, no conclusions about treatment effect can be made.

“Future randomised clinical trials are required to definitely evaluate the potential efficacy of MT compared with bMM in patients with ELVO presenting with mild neurological deficits,” they said.