Introduction The optimal management strategy for acute stroke due to isolated cervical internal carotid artery occlusion without intracranial involvement is unclear. Our study aimed to assess whether endovascular therapy (EVT) improves clinical outcomes in this specific patient population.

Aim of Study In this systematic review and meta-analysis, our objective is to compare the efficacy and safety of two approaches.

Methods A systematic search was conducted on comparative effect of EVT versus best medical treatment (BMT) in patient with stroke due to isolated ICA occlusion, utilizing PubMed, Scopus, and Web of Science databases following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). The comparison between the two approaches was conducted using a weighted random-effects model.

Results We included a total of 5 studies comprising 439 cases of acute stroke due to isolated ICA occlusion (291 treated with EVT and 148 with BMT). Our results suggest higher rates of favorable 90-day mRS outcomes in the EVT group (OR: 2.57, 95%CI: 1.07-6.19, p-value=0.03, I2:49%). We observed lower rates of 90-day mortality in the EVT group (OR: 0.83, 95% CI: 0.42-1.64, p-value=0.59, I2:0.0%), although this difference did not reach statistical significance. The incidence of symptomatic ICH did not differ significantly between the two groups (OR: 2.09, 95% CI: 0.73-6.0, p-value=0.17, I2:0.0%).

Conclusion Our literature review revealed better functional outcome in EVT group while maintaning comparable adverse event. Future comparative studies with special attention to the patient’s baseline status is warranted for better desicion in these patients.

Disclosure of Interest no.