Impact of stroke imaging selection modality on endovascular thrombectomy outcomes in the early and extended time windows: A meta-analysis.
Brain Behav
; 14(8): e3530, 2024 Aug.
Article
en En
| MEDLINE
| ID: mdl-39088741
ABSTRACT
BACKGROUND:
The effect of imaging selection modality on endovascular thrombectomy (EVT) clinical outcomes in patients with acute ischemic stroke due to large vessel occlusion (AIS-LVO) remains unclear. This study aims to compare post-EVT outcomes in patients with AIS-LVO who underwent basic imaging (computed tomography with or without computed tomography angiography) and advanced imaging (computed tomography perfusion or magnetic resonance imaging) in early and late time windows.METHOD:
A systematic literature search was conducted on PubMed, Cochrane Library, and Embase databases from inception until June 10, 2023. Studies investigating the relationship between the imaging selection modality and post-EVT outcomes in patients with AIS-LVO were retrieved. A random-effects model was used to pool the effect estimates of successful reperfusion, symptomatic intracranial hemorrhage (sICH), functional independence, and mortality. The meta-analysis was performed using Review Manager software v.4.3, and the outcomes were assessed using odds ratios (ORs) and 95% confidence intervals (CIs).RESULT:
A total of 13 non-randomized observational studies, comprising 19,694 patients, were included in this meta-analysis. In the early time windows, AIS-LVO patients receiving advanced imaging demonstrated a higher likelihood of functional independence (OR, 1.25, 95% CI, 1.08-1.46) and a lower risk of mortality (OR,.73 95% CI,.61-.86) compared to those receiving basic imaging. In the extended time windows, AIS-LVO patients undergoing advanced imaging had a lower mortality rate (OR,.79, 95% CI,.68-.92). Regardless of the time of onset, there were no significant differences between the two groups in terms of sICH or successful reperfusion.CONCLUSION:
Advanced imaging combined with EVT may achieve better clinical outcomes in patients with AIS-LVO. Further high-quality studies are needed to validate these findings.Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Trombectomía
/
Procedimientos Endovasculares
/
Accidente Cerebrovascular Isquémico
Límite:
Humans
Idioma:
En
Revista:
Brain Behav
Año:
2024
Tipo del documento:
Article
País de afiliación:
China