دورية أكاديمية
أعرض في EDS

A systematic review of randomized controlled trials of endovascular therapy for stroke on mortality and disability.

التفاصيل البيبلوغرافية
العنوان: A systematic review of randomized controlled trials of endovascular therapy for stroke on mortality and disability.
المؤلفون: Uchida K; Department of Neurosurgery, Hyogo Medical University, Nishinomiya, Japan; Department of Diagnostic Imaging, Cumming School of Medicine, University of Calgary, AB, Canada., Rinkel LA; Department of Diagnostic Imaging, Cumming School of Medicine, University of Calgary, AB, Canada; Departments of Neurology, Amsterdam UMC, University of Amsterdam, the Netherlands., Ospel JM; Department of Diagnostic Imaging, Cumming School of Medicine, University of Calgary, AB, Canada; Department of Neuroradiology, University Hospital of Basel, Switzerland., Diprose WK; Department of Diagnostic Imaging, Cumming School of Medicine, University of Calgary, AB, Canada; Department of Medicine, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand., Goyal M; Department of Diagnostic Imaging, Cumming School of Medicine, University of Calgary, AB, Canada. Electronic address: mgoyal2412@gmail.com.
المصدر: Journal of the neurological sciences [J Neurol Sci] 2024 May 15; Vol. 460, pp. 122991. Date of Electronic Publication: 2024 Apr 02.
نوع المنشور: Systematic Review; Journal Article; Meta-Analysis
اللغة: English
بيانات الدورية: Publisher: Elsevier Country of Publication: Netherlands NLM ID: 0375403 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1878-5883 (Electronic) Linking ISSN: 0022510X NLM ISO Abbreviation: J Neurol Sci Subsets: MEDLINE
أسماء مطبوعة: Original Publication: Amsterdam : Elsevier, <19 ->
مواضيع طبية MeSH: Endovascular Procedures*/methods , Randomized Controlled Trials as Topic*/methods, Humans ; Stroke/mortality ; Stroke/therapy ; Disabled Persons ; Disability Evaluation
مستخلص: Background: Endovascular treatment (EVT) has become standard of care for patients with anterior circulation large vessel occlusion (LVO) stroke, with indications having recently expanded to late time-window and large ischemic core patients. There is conflicting evidence on whether EVT reduces mortality or only disability. We performed a meta-analysis of randomized controlled trials (RCTs) to assess the effect of EVT on mortality and severe disability.
Methods: We systematically searched PubMed, Web of Science, Scopus, and Embase on November 15, 2023, to identify phase 3 RCTs comparing EVT to best medical treatment (BMT) in patients with anterior circulation LVO stroke in a common effects meta-analysis. The primary outcome was mortality at 3 months. Secondary outcomes were moderately severe or severe disability (modified Rankin Scale (mRS) score 4-5) at 3 months.
Results: 18 studies comparing EVT to BMT were included, with a total of 4309 patients; 2159 that were treated with EVT, and 2150 treated with BMT. Mortality was significantly lower in the EVT group than in the BMT group (odds ratio (OR): 0.81, 95% CI: 0.70-0.94). Proportions of moderately severe or severe disability (OR: 0.55, 95% CI: 0.48-0.62) were also significantly lower in patients treated with EVT.
Conclusions: This meta-analysis suggests that EVT reduces both mortality and moderately severe or severe disability in patients with anterior circulation LVO stroke.
Competing Interests: Declaration of competing interest K.U. reports lecturer fees from Daiichi Sankyo, Bristol Myers Squibb, Stryker, and Medtronic. J.M.O. Consultant for NICOLab. M.G. Grants to University of Calgary from Medtronic, Cerenovus, and NoNO Inc.; consultant on acute stroke intervention for Medtronic, Stryker, Microvention, and Mentice. L.A.R and W.K·D report no conflicting interests.
(Copyright © 2024. Published by Elsevier B.V.)
فهرسة مساهمة: Keywords: Acute ischemic stroke; Anterior circulation; Endovascular treatment; Mortality; Severe disability
تواريخ الأحداث: Date Created: 20240405 Date Completed: 20240510 Latest Revision: 20240607
رمز التحديث: 20240608
DOI: 10.1016/j.jns.2024.122991
PMID: 38579415
قاعدة البيانات: MEDLINE
الوصف
تدمد:1878-5883
DOI:10.1016/j.jns.2024.122991