Academic Journal
Endovascular treatment or general treatment: how should acute ischemic stroke patients choose to benefit from them the most? ; A systematic review and meta-analysis
| العنوان: | Endovascular treatment or general treatment: how should acute ischemic stroke patients choose to benefit from them the most? ; A systematic review and meta-analysis |
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| المؤلفون: | Yang, Weinan, Zhang, Lincheng, Yao, Qigu, Chen, Weiyan, Yang, Weiji, Zhang, Suqing, He, Lan, Li, Hong, Zhang, Yuyan |
| المساهمون: | National Natural Science Foundation of China, Science and Technology Project of Wenling City, Basic Public Welfare Research Project of Zhejiang Province |
| المصدر: | Medicine ; volume 99, issue 20, page e20187 ; ISSN 0025-7974 1536-5964 |
| بيانات النشر: | Ovid Technologies (Wolters Kluwer Health) |
| سنة النشر: | 2020 |
| الوصف: | Background: Acute ischemic stroke due to large-vessel occlusion is a leading cause of death and disability, and therapeutic time window was limited to 4.5 hour when treated with intravenous thrombolysis. It has been acknowledged that endovascular treatment (EVT) is superior to general treatment (only medication, including intravenous recombinant tissue plasminogen activator (rt-PA)) in improving the outcome of AIS since 2015. However, the benefits were limited to improvement of functional outcomes and functional independence. Hence, this meta-analysis was conducted to summarize the benefits of EVT for acute ischemic stroke, explore underlying indications of EVT for AIS patients and suggest implications for clinical practice and future research. Methods: A search was performed to identify eligible studies in PubMed, Scopus and Web of Science updated to February 5, 2019. Functional outcomes, the modified Rankin Scale (mRS) 0–1, mRS 0–2, all-cause mortality, symptomatic intracerebral hemorrhage and asymptomatic intracerebral hemorrhage (aICH) at 90 days were selected as outcomes. Data was pooled to calculate the odds ratio (OR) and 95% confidence interval (CI). Heterogeneity, subgroup analysis, sensitivity analysis and publication bias were also performed in this meta-analysis. Results: Eighteen studies comprising 3831 patients were included and analyzed in this meta-analysis. In comparison with general treatment, improved functional outcomes (mRS 0–1: OR = 1.68, 95% CI = 1.43–1.97, inconsistency index [ I 2] = 57%, P < .00001; mRS 0–2: OR = 1.78, 95% CI = 1.55–2.03, I 2 = 69%, P < .00001), reduced risk of all-cause mortality (OR = 0.82, 95% CI = 0.70–0.98, I 2 = 27%, P = .03) but higher risk of aICH (OR = 1.43, 95% CI = 1.05–1.95, I 2 = 0%, P = .02) at 90 days were found in AIS patients treated with EVT. Age < 70, National Institutes of Health Stroke Scale ≥20 and maximum delay for invention>5 hours could improve clinical outcomes following EVT. In sensitivity analysis, it showed that 2 ... |
| نوع الوثيقة: | article in journal/newspaper |
| اللغة: | English |
| DOI: | 10.1097/md.0000000000020187 |
| DOI: | 10.1097/MD.0000000000020187 |
| الاتاحة: | http://dx.doi.org/10.1097/md.0000000000020187 https://journals.lww.com/10.1097/MD.0000000000020187 |
| Rights: | http://creativecommons.org/licenses/by-nc/4.0 |
| رقم الانضمام: | edsbas.F29F75B8 |
| قاعدة البيانات: | BASE |
| DOI: | 10.1097/md.0000000000020187 |
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