A Meta-Analysis of Observational Evidence for the Use of Endovascular Thrombectomy in Proximal Occlusive Stroke Beyond 6 Hours in Patients with Limited Core Infarct / 신경중재치료의학
Neurointervention
;
: 59-68, 2017.
Article
in English
| WPRIM
| ID: wpr-730363
ABSTRACT
PURPOSE:
The safety and efficacy of endovascular thrombectomy (EVT) for patients with proximal occlusive stroke presenting beyond 6 hours and selected on the basis of favorable neuroimaging remains unclear. MATERIALS ANDMETHODS:
A systematic search was performed from four electronic databases from their inception to Jan 2017. A meta-analysis of outcomes from studies with patients treated beyond 6 hours was compared to those treated within the established 6 hour therapeutic window in randomized trials, selected using conventional imaging methods with CT/CT angiography.RESULTS:
A total of 8 articles met inclusion criteria for the study population (a prospective single-center study, 5 retrospective single-center studies and 2 retrospective multicenter studies). These were compared to the results of three prospective trials of patients treated within 6 hours selected using CT/CT angiography. For patients treated >6 hours and 6 hours and 12.5% for <6 hours, P<0.0001. Symptomatic intracranial hemorrhage was not significantly different (10.0% vs. 7.7%, P=0.33).CONCLUSION:
When compared to established methods of patient selection, EVT employed beyond 6 hours in those selected with imaging to exclude large core infarcts achieves similar rates of recanalization, and functional outcome but there is a significant increase in mortality despite no increase in symptomatic intracranial hemorrhage.
Full text:
Available
Index:
WPRIM (Western Pacific)
Main subject:
Perfusion
/
Angiography
/
Punctures
/
Prospective Studies
/
Retrospective Studies
/
Mortality
/
Thrombectomy
/
Patient Selection
/
Stroke
/
Intracranial Hemorrhages
Type of study:
Observational study
/
Prognostic study
/
Systematic reviews
Limits:
Humans
Language:
English
Journal:
Neurointervention
Year:
2017
Type:
Article
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