Table 3. . Comparison of functional and safety outcomes between EmboTrap, Trevo, and Solitaire after removing outlier studies, with pooled random effects estimates.
| Clinical and safety outcomes | Studies reporting outcomes (n) | Study arms reporting outcome (n) | EmboTrap† | Trevo† | Solitaire† | p-value (EmboTrap vs Trevo) | p-value (EmboTrap vs Solitaire) | p-value (Trevo vs Solitaire) | I2 (EmboTrap + Trevo) (95% CI) p-value |
I2 (EmboTrap + Solitaire) (95% CI) p-value |
I2 (Trevo + Solitaire) (95% CI) p-value |
Overall I2 (95% CI) p-value |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| mRS 0-2 at 90 days | 41 | 44 | 228/416 (54.9%) [48.7–61.1] |
1667/3160 (50.0%) [46.5–53.5] |
2018/4493 (46.2%) [43.8–48.6] |
0.157 | 0.008 | 0.085 | 39.0% (0.0–65.2) 0.047 |
52.7% (29.2–68.4) <0.001 |
66.3% (52.6–76.0) <0.001 |
65.2% (52.2–74.7) <0.001 |
| mRS at 90 days | 20 | 21 | 1.63 (0.94–2.32) [475] |
2.45 (1.93–2.98) [2598] |
2.73 (2.26–3.20) [2893] |
0.118 | 0.018 | 0.441 | 85.7% (57.2–96.9) <0.001 |
89.5% (79.2–96.0) <0.001 |
91.8% (83.9–96.7) <0.001 |
93.4% (87.9–96.9) <0.001 |
| 0 | . | . | 100 (21.1%) | 497 (19.1%) | 360 (12.5%) | . | . | . | . | . | . | . |
| 1 | . | . | 92 (19.4%) | 508 (19.6%) | 479 (16.6%) | . | . | . | . | . | . | . |
| 2 | . | . | 98 (20.6%) | 387 (14.9%) | 448 (15.5%) | . | . | . | . | . | . | . |
| 3 | . | . | 48 (10.1%) | 332 (12.8%) | 401 (13.9%) | . | . | . | . | . | . | . |
| 4 | . | . | 63 (13.3%) | 346 (13.3%) | 354 (12.2%) | . | . | . | . | . | . | . |
| 5 | . | . | 19 (4.0%) | 128 (4.9%) | 177 (6.1%) | . | . | . | . | . | . | . |
| 6 | . | . | 55 (11.6%) | 400 (15.4%) | 673 (23.3%) | . | . | . | . | . | . | . |
| Mortality at 90 days | 38 | 41 | 51/436 (12.2%) [9.4–15.7] |
481/3172 (15.7%) [12.4–19.6] |
679/3254 (18.5%) [16.0–21.3] |
0.159 | 0.023 | 0.260 | 62.6% (37.8–77.5) <0.001 |
73.0% (62.3–80.7) <0.001 |
71.6% (61.2–79.2) <0.001 |
71.6% (61.2–79.2) <0.001 |
| ENT or distal emboli | 24 | 25 | 24/537 (4.5%) [2.4–8.4] |
50/875 (6.4%) [4.3–9.5] |
157/1961 (7.3%) [5.5–9.6] |
0.366 | 0.167 | 0.624 | 40.9% (0.0–70.8) 0.077 |
62.0% (36.7–77.2) <0.001 |
58.6% (33.0–74.5) <0.001 |
59.1% (36.5–73.7) <0.001 |
| sICH | 42 | 44 | 22/687 (3.9%) [2.3–6.6] |
68/1076 (6.7%) [5.3–8.4] |
319/4629 (7.6%) [6.4–8.9] |
0.169 | 0.015 | 0.265 | 9.2% (0.0–46.1) 0.348 |
45.0% (17.9–63.1) 0.003 |
33.2% (0.0–55.4) 0.028 |
36.6% (8.4–56.1) 0.009 |
Dichotomous data for individual subgroups are expressed as n/n (%) [95% CI]; % calculated represents pooled random effects estimate, not fixed percentage).
Note: Outlier and influencer analyses were only performed if there were at least 5 studies per treatment group that reported the variable of interest. As such, outlier and influencer analyses were only performed for comparisons of mRS 0-2 at 90 days, mortality at 90 days, sICH, and ENT.
Ordinal data for individual subgroups are expressed as pooled median (95% CI) [n], along with raw frequency counts and percentages for each ordinal score. All pooled estimates for dichotomous data are derived from random-effects models using the DerSimonian-Laird procedure for estimation of between-study variance [15]; 95% CIs of the pooled results were computed using the Jackson method [16]. Pooled medians and corresponding 95% CIs were derived via random effects models using methods described by McGrath et al. [17] P-values for each pairwise comparison are provided using separate meta-regression analyses, considering the intervention as a categorical moderator. P-values for the overall heterogeneity (i.e., statistical inconsistency) among the included studies are obtained from Q-tests of heterogeneity. The estimated percentage of variability in effect size estimates that is due to heterogeneity rather than sampling error is given by I2 statistics and their corresponding 95% CIs [18]. I2 values are given for each subgroup comparison and for the overall study population.
CI: Confidence interval; ENT: Embolization to new territory; FPR: First pass recanalization; mRS: Modified Rankin Scale; mTICI: Modified thrombolysis in cerebral infarction; sICH: Symptomatic intracranial hemorrhage; TICI: Thrombolysis in cerebral infarction.