Details

Autor(en) / Beteiligte

• Uchida, Kazutaka
• Rinkel, Leon A.
• Ospel, Johanna M.
• Diprose, William K.
• Goyal, Mayank

Titel

A systematic review of randomized controlled trials of endovascular therapy for stroke on mortality and disability

Ist Teil von

• Journal of the neurological sciences, 2024-05, Vol.460, p.122991-122991, Article 122991

Ort / Verlag

Netherlands: Elsevier B.V

Erscheinungsjahr

2024

Link zum Volltext

Quelle

ScienceDirect Journals (5 years ago - present)

Beschreibungen/Notizen

• Endovascular treatment (EVT) has become standard of care for patients with anterior circulation large vessel occlusion (LVO) stroke, with indications having recently expanded to late time-window and large ischemic core patients. There is conflicting evidence on whether EVT reduces mortality or only disability. We performed a meta-analysis of randomized controlled trials (RCTs) to assess the effect of EVT on mortality and severe disability. We systematically searched PubMed, Web of Science, Scopus, and Embase on November 15, 2023, to identify phase 3 RCTs comparing EVT to best medical treatment (BMT) in patients with anterior circulation LVO stroke in a common effects meta-analysis. The primary outcome was mortality at 3 months. Secondary outcomes were moderately severe or severe disability (modified Rankin Scale (mRS) score 4–5) at 3 months. 18 studies comparing EVT to BMT were included, with a total of 4309 patients; 2159 that were treated with EVT, and 2150 treated with BMT. Mortality was significantly lower in the EVT group than in the BMT group (odds ratio (OR): 0.81, 95% CI: 0.70–0.94). Proportions of moderately severe or severe disability (OR: 0.55, 95% CI: 0.48–0.62) were also significantly lower in patients treated with EVT. This meta-analysis suggests that EVT reduces both mortality and moderately severe or severe disability in patients with anterior circulation LVO stroke. •Whether endovascular therapy for large vessel occlusion reduces mortality or only disability remain unclear.•And moreover, will this effect be allowed in patients with extended treatment time and large ischemic lesions?•Endovascular therapy reduces mortality and disability in patients even including the patients with large ischemic lesion.