Stent Retriever Thrombectomy in Acute Ischemic Stroke and Large Vessel Occlusion: Scoping Review with ☸️SAIMSARA.

Name: SAIMSARA Evidence Object vascular::STENT_RETRIEVER_PM
Creator: SAIMSARA
License: https://saimsara.com/license/

SAIMSARA

doi:10.62487/saimsara1e6b954c

SAIMSARA Journal

Machine-Readable Science • ISSN 3054-3991

Stent Retriever Thrombectomy in Acute Ischemic Stroke and Large Vessel Occlusion: Scoping Review with ☸️SAIMSARA.

Cardiac & Vascular Health

Issue 1, Volume 1, 2026

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DOI: 10.62487/saimsara1e6b954c

Editorial note

• Last update: 2026-05-30 09:25:20

What is this paper about

Stent retrievers are no longer just a device story; this review shows them as a full procedural ecosystem where aspiration strategy, device sizing, balloon-guide support, clot biology, and first-pass optimization shape real clinical success. The full read is valuable because it separates where stent-retriever thrombectomy is firmly evidence-based from where practice is still driven by anatomy, technique, emerging devices, and lower-certainty frontier applications.

Human-verified editorial review Verified by World ID proof-of-human. This editorial layer was submitted from a SAIMSARA account verified as a unique human.

Abstract: To synthesize the structured extraction evidence on SRs, emphasizing their clinical effectiveness, comparative performance against aspiration or older thrombectomy approaches, technical optimization, safety profile, mechanistic insights, and emerging indications. The review uses 221 references and builds its evidence map from 1130 original studies with 239540 total participants/sample observations (topic-deduplicated ΣN). Across the mapped evidence, stent-retriever thrombectomy emerges as a foundational platform for acute ischemic stroke from large vessel occlusion whose benefit is conditional rather than absolute, with the pivotal randomized signal of 60% versus 35% functional independence at 90 days anchoring its role alongside intravenous thrombolysis. Contemporary comparisons indicate that aspiration-first and stent-retriever-first strategies yield broadly similar functional outcomes, so the dominant message is that technique selection should be individualized to occlusion site, clot characteristics, and anatomy rather than applied uniformly. Modifiable procedural factors—including device sizing, balloon guide catheter support, and first-pass optimization—were repeatedly associated with better reperfusion and represent the most actionable levers for practice. The principal evidence gap concerns medium-vessel, posterior-circulation, and non-neurovascular applications, where future randomized strategy trials stratified by occlusion phenotype are needed to clarify when stent retrievers, aspiration, or combined approaches should be preferred.

Keywords: Stent retriever; Mechanical thrombectomy; Acute ischemic stroke; Large vessel occlusion; Recanalization; Reperfusion; Contact aspiration; First-pass effect; Thrombectomy devices; Functional outcome

Review Stats

Final search date and database lock: 2026-05-21 20:05:03 CEST
Plan: Pro (expanded craft tokens; source: PubMed)
Source: PubMed
Total Abstracts/Papers: 1551
Downloaded Abstracts/Papers: 1551
Included original and non-original Abstracts/Papers (all): 1310
Included original Abstracts/Papers (Vote counting by direction of effect): 1130
Reference Index (links used in paper): 221
Total participants/sample observations (topic deduplicated ΣN): 239540

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Reference Index (221)

[1] Stent-retriever thrombectomy after intravenous t-PA vs. t-PA alone in stroke. — https://doi.org/10.1056/nejmoa1415061
[2] Effect of Thrombectomy With Combined Contact Aspiration and Stent Retriever vs Stent Retriever Alone on Revascularization in Patients With Acute Ischemic Stroke and Large Vessel Occlusion: The ASTER2 Randomized Clinical Trial. — https://doi.org/10.1001/jama.2021.13827
[3] Effect of Endovascular Contact Aspiration vs Stent Retriever on Revascularization in Patients With Acute Ischemic Stroke and Large Vessel Occlusion: The ASTER Randomized Clinical Trial. — https://doi.org/10.1001/jama.2017.9644
[4] Aspiration versus stent retriever for posterior circulation stroke: A meta-analysis. — https://doi.org/10.1111/cns.14045
[5] Double Stent Retriever Technique for Mechanical Thrombectomy: A Systematic Review and Meta-Analysis. — https://doi.org/10.3174/ajnr.a8253
[6] Peripheral Non-cerebrovascular Arterial Stent Retriever Applications. — https://doi.org/10.1177/15385744211028727
[7] Biomechanics and hemodynamics of stent-retrievers. — https://doi.org/10.1177/0271678x20916002
[8] Stent Retriever AssIsted Lysis Technique with Tirofiban: A Potential Bailout Alternative to Angioplasty and Stenting. — https://doi.org/10.3174/ajnr.a8374

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