• Jia Li, Lixue Sun, Jia Zhenling, Chaoyan Song, and Yuchao Shan.
• Neurosurgery Third Department, Baoding No. 1 Central Hospital, Baoding City, Hebei Province, China.
• Medicine (Baltimore). 2025 Jan 31; 104 (5): e41395e41395.

BackgroundPrevious studies have not provided consistent findings regarding the efficacy of aspiration thrombectomy versus stent retriever thrombectomy in patients with acute internal carotid artery occlusion. This study aimed to evaluate the preferable endovascular technique (aspiration or stent retriever) and the impact of stent retriever utilization on both clinical and angiographic outcomes.MethodsWe collected potential scholarly articles from a variety of databases including the PubMed, Web of Science, Embase, Cochrane Library, ClinicalTrials.gov, and the World Health Organization, International Clinical Trials Registry Platform. The search spanned from the establishment of electronic databases up to March 2024. Additionally, gray literature was sourced from the references cited in the included literature reports. Statistical analysis of the combined data was performed using STATA version 11.0 (Stata Corporation, TX).ResultsOur analysis comprises a total of 4 studies, involving 759 participants in total. Among these individuals diagnosed with internal carotid artery occlusion, 435 were assigned to the aspiration group, while 324 were designated to the stent retriever group. The findings indicated a significant increase in the rate of successful reperfusion in the stent retriever group compared to the aspiration group. Furthermore, it was observed that the incidence of overall complications, intracerebral hemorrhage, embolization formation, puncture to reperfusion time, and onset to reperfusion time in the stent retriever group did not significantly exceed that in the aspiration group.ConclusionIn our review on intracranial internal carotid artery occlusion, stent retrievers outperformed direct aspiration in achieving successful reperfusion. However, further studies evaluating the effects of different approaches to internal carotid artery clot removal are required to confirm these results.Copyright © 2025 the Author(s). Published by Wolters Kluwer Health, Inc.

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