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Endovascular mechanical thrombectomy (eMT) is a reasonable alternative to intravenous (IV) thrombolysis in patients with acute ischemic stroke (AIS). In this study, we evaluated the effects of eMT on patient-oriented outcomes. Searches of MEDLINE, PubMed, and Embase were performed up to April 23, 2019. Studies that compared eMT with IV thrombolysis in AIS patients were included. The Cochrane’s Risk of Bias Tool was used to evaluate the quality of evidence. The primary outcome was 90-day functional independence (defined by a modified Rankin Scale ≤2). Results were reported as odds ratios (ORs) and 95% confidence intervals (CIs). A total of 4,126 potentially relevant articles were identified, of which 5 randomized controlled trials (RCTs) were included. The quality of evidence was low. The results of individual studies showed a benefit for eMT in clinical (OR: 0.73, 95% CI: 0.49-1.09), radiological (OR: 1.42, 95% CI: 0.83-2.42), and symptomatic (OR: 1.65, 95% CI: 0.74-3.71) outcomes. However, the quality of evidence was low. The eMT approach could improve 90-day functional independence and improve neurological outcomes in patients with AIS. However, we could not draw a solid conclusion because of a low quality of evidence, and the available RCTs are small and thus the evidence is not reliable. Better quality of evidence is needed to confirm the effects of eMT.’n in the Winter. Iron, Blood and Milk. Bravo.
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