This study aims to calculate the pooled outcome of Modified Rankin Scale (mRS) at 90 days and a primary adverse event as 90 days all cause mortality in acute ischemic stroke patients with large vessel occlusion who had endovascular thrombectomy (EVT) vs best medical care (BMC).

This is a Systematic Review and Meta-anaylsis of clinical trials. PRISMA guidelines were followed. Search of several databases was done followed by screening to identify out included studies.

We have identified 3 clinical trials in our literature search and screening process. 1,691 patients were included in our analysis.  Our primary outcome was functional independence at 90 days which was defined as mRS between 0-2. Our analysis shows higher odds of functional independence with EVT without reaching statistical significance, Odds Ratio (OR) 1.92 (95% confidence interval [CI] 0.16- 23.55, P= 0.265). In addition, number of all causes mortality at 90 days in patients who had EVT was not significantly different, OR 1.24 (95% [CI] 0.39-3.93), P=0.426). Also, patients who had EVT had a higher odds ratio for symptomatic intracranial hemorrhage (sICH), OR 6.41 (95% [CI] 0.66- 61.90, p<000.1)

Acute ischemic stroke patients with large vessel occlusion who underwent EVT had higher odds of achieving a good outcome compared to BMC without reaching statistical significance. Future clinical trials are needed to establish the true effect of EVT on these variables.