دورية أكاديمية
Mechanical Thrombectomy in Patients with a Large Ischemic Volume at Presentation: Systematic Review and Meta-Analysis
العنوان: | Mechanical Thrombectomy in Patients with a Large Ischemic Volume at Presentation: Systematic Review and Meta-Analysis |
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المؤلفون: | Basile Kerleroux, Kevin Janot, Jean François Hak, Johannes Kaesmacher, Wagih Ben Hassen, Joseph Benzakoun, Catherine Oppenheim, Denis Herbreteau, Heloise Ifergan, Nicolas Bricout, Hilde Henon, Takeshi Yoshimoto, Manabu Inoue, Arturo Consoli, Vincent Costalat, Olivier Naggara, Bertrand Lapergue, Federico Cagnazzo, Grégoire Boulouis |
المصدر: | Journal of Stroke, Vol 23, Iss 3, Pp 358-366 (2021) |
بيانات النشر: | Korean Stroke Society, 2021. |
سنة النشر: | 2021 |
المجموعة: | LCC:Diseases of the circulatory (Cardiovascular) system |
مصطلحات موضوعية: | stroke, ischemic stroke, thrombectomy, Diseases of the circulatory (Cardiovascular) system, RC666-701 |
الوصف: | The benefits of mechanical thrombectomy (MT) for patients with acute ischemic stroke (AIS) and a large ischemic core (LIC) at presentation are uncertain. We aimed to obtain up-to-date aggregate estimates of the outcomes following MT in patients with volumetrically assessed LIC. We conducted a Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA)-conformed, PROSPERO-registered, systematic review and meta-analysis of studies that included patients with AIS and a baseline LIC treated with MT, reported ischemic core volume quantitatively, and included patients with a LIC defined as a core volume ≥50 mL. The search was restricted to studies published between January 2015 and June 2020. Random-effects-meta-analysis was used to assess the effect of MT on 90-day unfavorable outcome (i.e., modified Rankin Scale [mRS] 3–6), mortality, and symptomatic intracranial hemorrhage (sICH) occurrence. Sensitivity analyses were performed for imaging-modality (computed tomography-perfusion or magnetic resonance-diffusion weighted imaging) and LIC-definition (≥50 or ≥70 mL). We analyzed 10 studies (954 patients), including six (682 patients) with a control group, allowing to compare 332 patients with MT to 350 who received best-medical-management alone. Overall, after MT the rate of patients with mRS 3–6 at 90 days was 74% (99% confidence interval [CI], 67 to 84; Z-value=7.04; I2=92.3%) and the rate of 90-day mortality was 36% (99% CI, 33 to 40; Z-value=–7.07; I2=74.5). Receiving MT was associated with a significant decrease in mRS 3–6 odds ratio (OR) 0.19 (99% CI, 0.11 to 0.33; P |
نوع الوثيقة: | article |
وصف الملف: | electronic resource |
اللغة: | English |
تدمد: | 2287-6391 2287-6405 |
Relation: | http://www.j-stroke.org/upload/pdf/jos-2021-00724.pdf; https://doaj.org/toc/2287-6391; https://doaj.org/toc/2287-6405 |
DOI: | 10.5853/jos.2021.00724 |
URL الوصول: | https://doaj.org/article/20de4db41b2e4a8996d8f6e9a106ec0a |
رقم الأكسشن: | edsdoj.20de4db41b2e4a8996d8f6e9a106ec0a |
قاعدة البيانات: | Directory of Open Access Journals |
تدمد: | 22876391 22876405 |
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DOI: | 10.5853/jos.2021.00724 |