Literature DB >> 31321515

Endovascular therapy versus intravenous thrombolysis in cervical artery dissection-related ischemic stroke: a meta-analysis.

Jueying Lin1, Yawei Liang2, Juexin Lin2.   

Abstract

BACKGROUND: The purpose of our meta-analysis is to evaluate the endovascular therapy (EVT) in patients with cervical artery dissection (CAD)-related acute ischemic stroke (AIS) by comparing its efficacy and safety with the ones of intravenous thrombolysis (IVT).
METHODS: A systematic search on EVT to CAD-related ischemic stroke is performed. The meta-analysis models are applied to calculate either the risk ratio (RR) with 95% confidence interval (CI) or pooled proportions with 95% CI of favorable functional outcome (mRS = 0-2), excellent functional outcome (mRS = 0-1), symptomatic intracranial hemorrhage (SICH), mortality and recurrent stroke between EVT and IVT in CAD-related stroke. The differences between the two treatment groups are analyzed by the pooled odds ratio value and Chi-squared test.
RESULTS: A total of 190 patients given EVT and 139 IVT-alone patients are included. By comparing EVT alone and IVT alone, patients treated with EVT alone are more likely to experience favorable outcomes than those treated with IVT alone (71.2% vs 53.4%). Besides, there is no significant difference in excellent functional outcome, SICH, mortality and recurrent stroke between the EVT-alone and IVT-alone groups (all P > 0.05). Towards general EVT (EVT with or without IVT), the outcomes are not significantly different from those of IVT alone except for a higher mortality rate (10.2% vs 3.2%).
CONCLUSION: Based on our findings, EVT is considered to be more efficacious than IVT for CAD-related AIS patients. Although EVT alone tends to be safe and promising, its safety needs to be further evaluated, particularly for EVT separating from IVT therapy.

Entities:  

Keywords:  Cervical artery dissection; Endovascular therapy; Intravenous thrombolysis; Ischemic stroke; Meta-analysis

Year:  2019        PMID: 31321515     DOI: 10.1007/s00415-019-09474-y

Source DB:  PubMed          Journal:  J Neurol        ISSN: 0340-5354            Impact factor:   4.849


  6 in total

1.  Reperfusion therapy in patients with acute ischaemic stroke caused by cervical artery dissection.

Authors:  L A Crespo Araico; R Vera Lechuga; A Cruz-Culebras; C Matute Lozano; A de Felipe Mimbrera; P Agüero Rabes; E Viedma Guiard; C Estévez Fraga; J Masjuan Vallejo
Journal:  Neurologia (Engl Ed)       Date:  2017-01-12

2.  Strengthening the Reporting of Observational Studies in Epidemiology (STROBE): explanation and elaboration.

Authors:  Jan P Vandenbroucke; Erik von Elm; Douglas G Altman; Peter C Gøtzsche; Cynthia D Mulrow; Stuart J Pocock; Charles Poole; James J Schlesselman; Matthias Egger
Journal:  Int J Surg       Date:  2014-07-18       Impact factor: 6.071

Review 3.  Evolution of the Modified Rankin Scale and Its Use in Future Stroke Trials.

Authors:  Joseph P Broderick; Opeolu Adeoye; Jordan Elm
Journal:  Stroke       Date:  2017-06-16       Impact factor: 7.914

Review 4.  Safety and Efficacy of Thrombolysis in Cervical Artery Dissection-Related Ischemic Stroke: A Meta-Analysis of Observational Studies.

Authors:  Jueying Lin; Yefei Sun; Shanshan Zhao; Junjie Xu; Chuansheng Zhao
Journal:  Cerebrovasc Dis       Date:  2016-05-21       Impact factor: 2.762

5.  Endovascular therapy versus intravenous thrombolysis in cervical artery dissection ischemic stroke - Results from the SWISS registry.

Authors:  Christopher Traenka; Simon Jung; Jan Gralla; Rebekka Kurmann; Christoph Stippich; Barbara Goeggel Simonetti; Henrik Gensicke; Hubertus Mueller; Karl Lovblad; Ashraf Eskandari; Francesco Puccinelli; Jochen Vehoff; Johannes Weber; Susanne Wegener; Levke Steiner; Georg Kägi; Andreas Luft; Roman Sztajzel; Urs Fischer; Leo H Bonati; Nils Peters; Patrik Michel; Philippe A Lyrer; Marcel Arnold; Stefan T Engelter
Journal:  Eur Stroke J       Date:  2018-01-03

6.  Therapeutic Decision Making in Acute Stroke due to Carotid Artery Dissection: A Potential Role for Percutaneous Vascular Intervention following Intravenous Thrombolysis.

Authors:  J B Lewis; A Merwick; R Ó Laoide; A O'Hare; C McGuigan
Journal:  Case Rep Vasc Med       Date:  2013-02-21
  6 in total
  3 in total

1.  Intravenous Thrombolysis Benefits Mild Stroke Patients With Large-Artery Atherosclerosis but No Tandem Steno-Occlusion.

Authors:  Dapeng Wang; Lulu Zhang; Xiaowei Hu; Juehua Zhu; Xiang Tang; Dongxue Ding; Hui Wang; Yan Kong; Xiuying Cai; Longting Lin; Qi Fang
Journal:  Front Neurol       Date:  2020-05-05       Impact factor: 4.003

2.  Mechanical thrombectomy in patients with cervical artery dissection and stroke in the anterior or posterior circulation - a multicenter analysis from the German Stroke Registry.

Authors:  Ludwig Schlemm; Regina von Rennenberg; Eberhard Siebert; Georg Bohner; Fabian Flottmann; Gabor C Petzold; Götz Thomalla; Matthias Endres; Christian H Nolte
Journal:  Neurol Res Pract       Date:  2021-05-03

3.  Meta-Analysis of the Effectiveness and Safety of Intravenous Thrombolysis in Patients with Acute Cerebral Infarction.

Authors:  Huili Wu; Weiping Gong; Yanyan Tang; Wuhua Xu; Ying Zhou; Xianjun Liu
Journal:  Comput Math Methods Med       Date:  2021-12-07       Impact factor: 2.238

  3 in total

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