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.
Artigo
em Inglês
| 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.
Texto completo:
DisponíveL
Índice:
WPRIM (Pacífico Ocidental)
Assunto principal:
Perfusão
/
Angiografia
/
Punções
/
Estudos Prospectivos
/
Estudos Retrospectivos
/
Mortalidade
/
Trombectomia
/
Seleção de Pacientes
/
Acidente Vascular Cerebral
/
Hemorragias Intracranianas
Tipo de estudo:
Estudo observacional
/
Estudo prognóstico
/
Revisões Sistemáticas Avaliadas
Limite:
Humanos
Idioma:
Inglês
Revista:
Neurointervention
Ano de publicação:
2017
Tipo de documento:
Artigo
Similares
MEDLINE
...
LILACS
LIS