Comparing efficacy and safety of direct aspiration versus stent retriever thrombectomy in acute basilar artery occlusion: A systematic review and meta-analysis
Bibliographic record
Abstract
Acute basilar artery occlusion (BAO) can lead to severe stroke and is linked to significant disability or death if not treated. This meta-analysis evaluated the effectiveness and safety of first-line thrombectomy options: Direct Aspiration (DA) and Stent Retriever Thrombectomy (SRT) for acute BAO. Electronic databases, including PubMed, Cochrane Central, ScienceDirect, Embase, and Web of Science were searched from inception until July 2025. Studies were included if they were RCTs or observational cohorts involving adults with acute BAO, comparing DA and SRT. The risk ratios (RR) and mean differences (MD) were pooled using Review Manager version. The Newcastle–Ottawa Scale (NOS) was used to assess quality. This meta-analysis included fifteen observational studies pooling 2214 patients. DA significantly increased the postoperative successful (RR = 1.04; 95% CI: 1.01 to 1.07; p = 0.008) and complete (RR = 1.19; 95% CI: 1.03 to 1.38; p = 0.02) recanalization compared to SRT. Similarly, symptomatic intracerebral hemorrhage (sICH) incidence was significantly reduced in the DA arm (RR = 0.65; 95% CI: 0.44 to 0.97; p = 0.04). DA is also associated with decreased procedural duration (MD = −35.17 min; 95% CI: −47.97 to −22.37; p < 0.00001). Meanwhile other outcomes, including postoperative mortality, rescue therapy, and favorable functional outcome were comparable between the 2 groups. DA demonstrated superior recanalization rates, reduced procedural duration, and a lower incidence of sICH compared to SRT. However, both techniques were comparable regarding other outcomes. Nevertheless, the observational study design limits the strength of the conclusion drawn.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.010 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".