Your browser doesn't support javascript.
A Meta-Analysis of Prognostic Factors in Patients with Posterior Circulation Stroke after Mechanical Thrombectomy.
Xun, Kai; Mo, Jiahang; Ruan, Shunyi; Dai, Jinyao; Zhang, Wenting; Lv, Yuqi; Du, Nannan; Chen, Shengyue; Shen, Zefeng; Wu, Yuanxi.
  • Xun K; Department of Emergency, HwaMei Hospital, University of Chinese Academy of Sciences, Ningbo, China.
  • Mo J; The Second Clinical Medicine School, Zhejiang Chinese Medical University, Hangzhou, China.
  • Ruan S; The Second Clinical Medicine School, Zhejiang Chinese Medical University, Hangzhou, China.
  • Dai J; The Second Clinical Medicine School, Zhejiang Chinese Medical University, Hangzhou, China.
  • Zhang W; The Second Clinical Medicine School, Zhejiang Chinese Medical University, Hangzhou, China.
  • Lv Y; The Second Clinical Medicine School, Zhejiang Chinese Medical University, Hangzhou, China.
  • Du N; The Second Clinical Medicine School, Zhejiang Chinese Medical University, Hangzhou, China.
  • Chen S; The Second Clinical Medicine School, Zhejiang Chinese Medical University, Hangzhou, China.
  • Shen Z; Department of General Surgery, School of Medicine, Sir Run Run Shaw Hospital, Zhejiang University, Hangzhou, China.
  • Wu Y; The Second Clinical Medicine School, Zhejiang Chinese Medical University, Hangzhou, China, Rich7048635@aliyun.com.
Cerebrovasc Dis ; 50(2): 185-199, 2021.
Article in English | MEDLINE | ID: covidwho-1348201
Semantic information from SemMedBD (by NLM)
1. Cerebrovascular accident PROCESS_OF Patients
Subject
Cerebrovascular accident
Predicate
PROCESS_OF
Object
Patients
2. Prognosis bad COEXISTS_WITH Cerebrovascular accident
Subject
Prognosis bad
Predicate
COEXISTS_WITH
Object
Cerebrovascular accident
3. Mechanical thrombectomy TREATS Cerebrovascular accident
Subject
Mechanical thrombectomy
Predicate
TREATS
Object
Cerebrovascular accident
4. Mechanical thrombectomy TREATS Patients
Subject
Mechanical thrombectomy
Predicate
TREATS
Object
Patients
5. Cerebrovascular accident PROCESS_OF Patients
Subject
Cerebrovascular accident
Predicate
PROCESS_OF
Object
Patients
6. Prognosis bad COEXISTS_WITH Cerebrovascular accident
Subject
Prognosis bad
Predicate
COEXISTS_WITH
Object
Cerebrovascular accident
7. Mechanical thrombectomy TREATS Cerebrovascular accident
Subject
Mechanical thrombectomy
Predicate
TREATS
Object
Cerebrovascular accident
8. Mechanical thrombectomy TREATS Patients
Subject
Mechanical thrombectomy
Predicate
TREATS
Object
Patients
ABSTRACT

BACKGROUND:

Posterior circulation stroke is characterized by poor prognosis because its optimal thrombolysis "time window" is always missed. After mechanical thrombectomy (MT), the recanalization rate of posterior circulation obstruction is significantly increased, but prognosis remains poor. To best manage patients, prognostic factors are needed to inform MT triaging after posterior circulation stroke.

METHODS:

A systematic literature search was done for the period through April 2020. Studies included those with posterior circulation stroke cases that underwent MT. The primary outcome measure in this study was the modified Rankin Scale on day 90.

RESULTS:

No outcome differences were found in gender, atrial fibrillation, smoking, and coronary artery disease (OR = 1.07, 95% CI 0.90-1.28; OR = 1.02, 95% CI 0.82-1.26; OR = 1.26, 95% CI 0.94-1.68; and OR = 0.84, 95% CI 0.58-1.22, respectively). Hypertension, diabetes mellitus, and previous stroke correlated with poorer prognosis (OR = 0.61, 95% CI 0.48-0.77; OR = 0.60, 95% CI 0.50-0.73; and OR = 0.74, 95% CI 0.55-0.99, respectively). However, hyperlipidemia correlated with better prognosis (OR = 1.28, 95% CI 1.04-1.58).

CONCLUSION:

Our analysis indicates that hypertension, diabetes mellitus, or previous stroke correlate with poorer outcomes. Intriguingly, hyperlipidemia correlates with better prognosis. These factors may help inform triage decisions when considering MT for posterior circulation stroke patients. However, large, multicenter, randomized controlled trials are needed to validate these observations.
Subject(s)
Keywords

Full text: Available Collection: International databases Database: MEDLINE Main subject: Outcome and Process Assessment, Health Care / Patient Admission / Practice Patterns, Physicians' / Thrombectomy / Ischemic Stroke / COVID-19 Type of study: Controlled clinical trial / Diagnostic study / Etiology study / Observational study / Prognostic study / Randomized controlled trials / Reviews / Risk factors Limits: Aged / Female / Humans / Male / Middle aged Language: English Journal: Cerebrovasc Dis Journal subject: Vascular Diseases / Brain Year: 2021 Document Type: Article Affiliation country: 000512609

Full text: Available Collection: International databases Database: MEDLINE Main subject: Outcome and Process Assessment, Health Care / Patient Admission / Practice Patterns, Physicians' / Thrombectomy / Ischemic Stroke / COVID-19 Type of study: Controlled clinical trial / Diagnostic study / Etiology study / Observational study / Prognostic study / Randomized controlled trials / Reviews / Risk factors Limits: Aged / Female / Humans / Male / Middle aged Language: English Journal: Cerebrovasc Dis Journal subject: Vascular Diseases / Brain Year: 2021 Document Type: Article Affiliation country: 000512609