{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T18:16:22Z","timestamp":1783361782287,"version":"3.54.6"},"reference-count":21,"publisher":"Oxford University Press (OUP)","issue":"7","license":[{"start":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T00:00:00Z","timestamp":1783296000000},"content-version":"vor","delay-in-days":5,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,7,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>The best first-line mechanical thrombectomy treatment for acute ischemic stroke (AIS) caused by anterior large vessel occlusion (LVO) remains unclear despite four randomised controlled trials (RCTs). We compared the effectiveness and safety of the first-line combined stent retriever (SR)\u00a0+\u00a0contact aspiration (CA) approach with SR or CA alone for the treatment of AIS due to LVO.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients and Methods<\/jats:title>\n                    <jats:p>This retrospective analysis combines individual patient data from 3 large multicenter, RCTs: ASTER, ASTER2, and VECTOR. The primary outcome was the proportion of patients who achieved favourable recanalisation (defined as a modified Thrombolysis in Cerebral Infarction score of 2b, 2c or 3) after the first-line treatment, without a second-line rescue technique. Secondary outcomes included the first pass effect, disability assessed by the 90-day modified Rankin Scale (mRS) score, 24-hour change in National Institutes of Health Stroke Scale (NIHSS), 90-day all-cause mortality, and serious procedure-related adverse events.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 1,185 included patients, 434 received the combined approach, 414 received CA alone, and 337 received SR alone. Baseline characteristics were similar among groups. After adjusting for factors using propensity score weighting, the primary outcome was achieved more often in the combined group compared to CA alone (risk ratio\u00a0=\u00a01.95; 95% CI, 1.42 to 2.68; P\u00a0&amp;lt;\u00a00.001) or SR alone (Odds ratio\u00a0=\u00a01.70; 95% CI, 1.21 to 2.38; P\u00a0=\u00a0.002). There were no significant differences in 24-hour change in NIHSS, 90-day mRS, or adverse events among the groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In this pooled analysis of 3 RCTs, the combined approach as the first-line treatment for anterior circulation LVO increased the probability of achieving favourable recanalisation without the need for a second-line approach, compared to CA or SR alone but no impact on clinical outcomes was detected.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/esj\/aakag077","type":"journal-article","created":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T17:35:35Z","timestamp":1783359335000},"source":"Crossref","is-referenced-by-count":0,"title":["Combined stent retriever and contact aspiration improves first-line recanalisation but not clinical outcomes: a pooled analysis of the ASTER, ASTER2, and VECTOR trials"],"prefix":"10.1093","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7611-7753","authenticated-orcid":false,"given":"Gaultier","family":"Marnat","sequence":"first","affiliation":[{"name":"Neuroradiology, University Hospital Centre Bordeaux , Bordeaux ,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bertrand","family":"Lapergue","sequence":"additional","affiliation":[{"name":"Neurology, Hospital Foch , Suresnes ,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1354-4328","authenticated-orcid":false,"given":"Michel","family":"Piotin","sequence":"additional","affiliation":[{"name":"Neuroradiology, Rothschild Foundation Hospital , Paris ,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julien","family":"Labreuche","sequence":"additional","affiliation":[{"name":"Biostatistics, Lille University Hospital , Lille 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Neuroradiology and Centre d'Investigation Clinique \u2013 Innovation Technologique (CIC-IT) 1415, Regional University Hospital Centre , Tours ,","place":["France"]},{"name":"Universit\u00e9 de Tours, INSERM, Imaging Brain & Neuropsychiatry iBraiN U1253 , 37032 Tours ,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean-Christophe","family":"Gentric","sequence":"additional","affiliation":[{"name":"Neuroradiology, Brest University Hospital Centre , Brest ,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8146-5886","authenticated-orcid":false,"given":"Vincent","family":"L\u2019Allinec","sequence":"additional","affiliation":[{"name":"Radiology, Angers University Hospital , Angers ,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fr\u00e9d\u00e9ric","family":"Claren\u00e7on","sequence":"additional","affiliation":[{"name":"Neuroradiology, 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Paris Cit\u00e9, Neurology Lariboisi\u00e8re University Hospital, FHU Neurovasc, Institut Universitaire de France, U1144 , Paris ,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fr\u00e9d\u00e9ric","family":"Bourdain","sequence":"additional","affiliation":[{"name":"Neurology, Centre Hospitalier de la C\u00f4te Basque , Bayonne ,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sebastian","family":"Richter","sequence":"additional","affiliation":[{"name":"Radiology, H\u00f4pital Fran\u00e7ois Mitterrand , Pau ,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emmanuel","family":"Houdart","sequence":"additional","affiliation":[{"name":"Neuroradiology, H\u00f4pital Lariboisi\u00e8re , Paris ,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicolas","family":"Bricout","sequence":"additional","affiliation":[{"name":"Neuroradiology, Lille University 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