SAIMSARA Journal

Machine-Readable Science • ISSN 3054-3991

Aspiration Thrombectomy in Stroke, STEMI, Pulmonary Embolism, and DVT: Scoping Review with ☸️SAIMSARA.

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Cardiac & Vascular Health

Issue 1, Volume 1, 2026

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DOI: 10.62487/saimsara2481f0d4

Editorial note
• Last update: 2026-05-25 09:39:50
What is this paper about
Aspiration thrombectomy is not a universal “clot-removal solution”: this evidence map shows where it works best, where it fails to improve outcomes, and why stroke, STEMI, PE, DVT, and peripheral indications must be judged separately. The full read gives a clinically useful cross-territory synthesis of device choice, catheter strategy, thrombus biology, rescue techniques, safety signals, and indication-specific evidence gaps.
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Abstract: To map and synthesize the clinical, procedural, mechanistic, and device-related evidence on aspiration thrombectomy across vascular territories, with emphasis on recurrent findings, treatment selection, safety signals, and research gaps. The review uses 524 references and builds its evidence map from 1812 original studies with 1720187 total participants/sample observations (topic-deduplicated ΣN). Overall, this scoping review suggests that aspiration thrombectomy is a technically effective reperfusion and debulking strategy whose clinical value is highly context-dependent rather than universally beneficial. In acute ischemic stroke, first-line aspiration was associated with broadly comparable functional outcomes to stent retrievers (e.g., 52% vs 50% mRS 0–2) and often shorter procedures, while in STEMI, routine aspiration during primary PCI did not improve clinical outcomes and was linked to an excess stroke signal in one major trial. In contrast, aspiration showed consistent hemodynamic and safety signals in intermediate- and high-risk pulmonary embolism and feasibility across diverse venous, peripheral, and visceral indications. These patterns support selective, image-, clot-, and anatomy-guided use rather than an aspiration-first paradigm everywhere. Future indication-specific randomized trials linking clot phenotype, catheter-to-vessel sizing, and rescue thresholds to outcomes are the key next step.

Keywords: Aspiration thrombectomy; Mechanical thrombectomy; Acute ischemic stroke; Large vessel occlusion; Stent retriever; Pulmonary embolism; Deep vein thrombosis; Catheter aspiration; Reperfusion; Thrombus removal

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Reference Index (524)

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