A Meta-Analysis of Observational Intra-Arterial Stroke Therapy Studies Using the Merci Device, Penumbra System, and Retrievable Stents

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Fig 1.
Outlines of the search and selection process.
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Fig 2.
The relation (with 95% confidence limits) between the mean procedural time to recanalization and independent functional outcome (mRS ≤2) in the different studies. P value for the Cuzick test of trend is .06. The square indicates the MD; the triangle, the PS; and the circle, the RS.

Table 1:

Characteristics of the included studies

Author	Year	Centers	Design	Device Used	Size (Patients)	Mean Age (yr)	Median NIHSS Score
Aleu et al²¹	2011	Single	Retrospective	Ret stent	54	68	19
Castaño et al²⁴	2010	Single	Retrospective	Ret stent	20	65.6	19
Devlin et al³⁷	2007	Single	Retrospective	Merci	25	63	18
Frei et al¹⁸	2011	Multi	Prospective	Penumbra	53	63	18
Grunwald et al³⁸	2009	Single	Retrospective	Penumbra	29	58.4	20
Kang et al²⁵	2011	Multi	Retrospective	Penumbra	22	59	18.1
Kulcsár et al²⁶	2010	Single	Prospective	Penumbra	27	66	14
Lee et al³⁹	2009	Single	Retrospective	Merci	17	67	18
Menon et al²³	2011	Single	Prospective	Penumbra	27	61.5	18
Menon et al⁴⁰	2012	Single	Prospective	Ret stent	14	62.1	14
Pereira et al²²	2011	Single	Prospective	Ret stent	25	66.3	18.7
Penumbra Pivotal Stroke Trial Investigators¹³	2009	Multi	Retrospective	Penumbra	125	63.5	20
Smith et al¹²	2005	Multi	Retrospective	Merci	151	67	20
Smith et al¹⁶	2008	Multi	Retrospective	Merci	164	68	19
Struffert et al⁴¹	2009	Single	Prospective	Penumbra	15	60.3	14
Tarr et al⁴²	2010	Multi	Prospective	Penumbra	157	65	18.1

Table 2:

Procedural outcomes

Author	Device Used	Mean/Median Puncture to Recanalization Time (min)	TIMI 2–3 Recanalization (No.) (%)
Aleu et al²¹	RS	51	50 of 54 (92.6)
Castaño et al²⁴	RS	70	18 of 20 (90)^{^a}
Devlin et al³⁷	MD	108^{^b}	14 of 25 (56)
Frei et al¹⁸	PS	52	47 of 53 (88.7)
Grunwald et al³⁸	PS	51	25 of 29 (86.2)
Kang et al²⁵	PS	40	22 of 22 (100)^{^a}
Kulcsár et al²⁶	PS	97	25 of 27 (92.6)^{^a}
Lee et al³⁹	MD	129.6^{^b}	13 of 17 (76.5)
Menon et al²³	PS	80	23 of 27 (85.2)
Menon et al⁴⁰	RS	84	12 of 14 (85.7)
Pereira et al²²	RS	42^{^c}	25 of 25 (100)
Penumbra Pivotal Stroke Trial Investigators¹³	PS	97	103 of 125 (82.4)
Smith et al¹²	MD	126^{^b}	72 of 151 (47.7)
Smith et al¹⁶	MD	96^{^b}	112 of 164 (68.3)
Struffert et al⁴¹	PS	60^{^c}	12 of 15 (80)
Tarr et al⁴²	PS	41	137 of 157 (87.3)