Risk of Early Recurrent Stroke and Thrombotic Events After Reperfusion Therapy in Acute Ischemic Stroke: A Meta-Analysis
Published on: November 25, 2025
Reperfusion therapies, when administered to patients experiencing an acute ischemic stroke up to 24 hours after symptom onset, did not lead to a greater risk of either recurrent stroke or nonstroke thrombotic events (NSTE) within a 90-day period when compared with the best medical therapy available, new research shows. The meta-analysis included adults with acute ischemic stroke. comparing reperfusion treatment with best medical management (MED). In 15 randomized controlled trials (RCTs) involving 4,898 patients, there was no statistical difference in early recurrent stroke rates between endovascular thrombectomy (EVT) and MED, at 5.5% vs. 4.5%. Similarly, nine RCTs involving 7,193 patients found no difference in this outcome between intravenous thrombolysis and MED, at 2% vs. 1.8%. The analysis also reported no significant differences in non-symptomatic territorial embolism, with 14 RCTs (4,033 patients) comparing EVT (3.1%) to MED (3.1%) and five RCTs (4,961 patients) comparing intravenous thrombolysis (2%) to MED (2.2%).