This study aims to evaluate the safety and efficacy of mechanical thrombectomy associated with standard medical treatment compared to standard medical treatment alone for the treatment of patients with acute ischemic stroke.

A systematic review and meta-analysis of randomized controlled trials was conducted. An electronic search was performed in the Medline, Cochrane Library, Lilacs/Ibecs, and Embase databases, in addition to complementary searches. The selection of studies and data collection was carried out by two researchers independently.

The final analysis included 16 publications, referring to 15 studies. The mechanical thrombectomy was associated to a reduction in the risk of death (16.81% vs. 20.13%; RR=0.85, p-value=0.04), improvement in the number of patients with functional independence after 90 days (45.65% vs. 27.45%; RR=1.65, p-value<0.01) and improvement in the rate of revascularization (76.2% vs. 33.85%; RR=2.20, p-value<0.01). There was no significant difference in terms of symptomatic intracranial hemorrhage (4.78% vs. 3.88%; RR=1.27, p-value=0.21).

Thrombectomy associated with standard medical treatment is safe and efficacious for the treatment of patients with acute ischemic stroke when compared to standard medical treatment alone.