Congratulation to Islam Elgendy (Class of 2015 graduate, first author) and Ahmed Mahmoud (PGY3, coauthor) on their new article published in the Journal of American College Cardiology (JACC), the number one cardiology journal in the world. Their article entitled Mechanical Thrombectomy for Acute Ischemic Stroke: A Meta-Analysis of Randomized Trials is available online.
They conducted a meta-analysis of nine randomized controlled trials comparing mechanical thrombectomy plus intravenous thrombolysis with intravenous thrombolysis alone (usual care) for treatment of acute ischemic stroke involving a major cerebral artery. The study illustrated better outcomes with mechanical thrombectomy with 45% increase in the incidence of achieving a good functional outcome compared to standard care (RR: 1.45; 95% confidence interval [CI]: 1.22 to 1.72; p < 0.0001) and 65% increase in achieving an excellent functional outcome (RR: 1.67; 95% CI: 1.27 to 2.19; p < 0.0001) at 90 days. There was a trend toward reduced all-cause mortality with mechanical thrombectomy that did not achieve statistical significance (RR: 0.86; 95% CI: 0.72 to 1.02; p = 0.09). The results of the current study supports the use of mechancial thrombectomy as an adjunct to intravenous thrombolysis for treatment of acute ischemic stroke patients.