Jian Wang1,2, Jiacheng Qian1, Lu Fan1, Yujie Wang3. 1. Cerebrovascular Disease Center, Department of Neurology, People's Hospital, China Medical University, 33 Wenyi Road, Shenhe District, Shenyang, 110016, People's Republic of China. 2. Neurosurgery Department, The First Hospital of China Medical University, 155 Nanjing North Road, Heping District, Shenyang, 110001, People's Republic of China. 3. Cerebrovascular Disease Center, Department of Neurology, People's Hospital, China Medical University, 33 Wenyi Road, Shenhe District, Shenyang, 110016, People's Republic of China. wangyujie196508@163.com.
Abstract
BACKGROUND AND PURPOSE: The efficacy and safety of mechanical thrombectomy (MT) for M2 segment occlusion of middle cerebral artery in patients with acute ischemic stroke (AIS) was investigated. METHODS: We searched PubMed and EMBASE from inception to 16 April 2019 for relevant studies, calculated the pool relative risks (RRs) of 3-month functional independence (modified Rankin scale score 0-2), death and symptomatic intracerebral hemorrhage (sICH) in MT for M2 segment occlusion in patients with AIS versus those of M1 segment or best medical care. RESULTS: Nine studies enrolling 2152 patients compared MT for patients with AIS of M2 segment occlusion and those of M1 segment occlusion. MT for M2 occlusion had a higher rate of 3-month functional independence compared to the patients with M1 occlusion. (RR 1.27, 95% CI 1.11-1.44, P < 0.001) and decreased death (RR 0.74; 95% CI 0.58-0.96, P = 0.022) with similar risk of sICH (RR 1.11; 95% CI 0.65-1.87, P = 0.707). Four studies enrolling 1016 patients compared MT and best medical care for patients with AIS of M2 occlusion. MT for M2 occlusion benefit more than best medical care on 3-month functional independence (RR 1.43, 95% CI 1.08-1.90, P = 0.011) and death (RR 0.46; 95% CI 0.22-0.96, P = 0.022) with similar risk of sICH (RR 1.65; 95% CI 0.66-4.13; P = 0.286). CONCLUSION: MT for M2 segment benefit patients with AIS on 3-month functional independence compared with that of M1 segment or medical care, without increasing the risk of sICH.
BACKGROUND AND PURPOSE: The efficacy and safety of mechanical thrombectomy (MT) for M2 segment occlusion of middle cerebral artery in patients with acute ischemic stroke (AIS) was investigated. METHODS: We searched PubMed and EMBASE from inception to 16 April 2019 for relevant studies, calculated the pool relative risks (RRs) of 3-month functional independence (modified Rankin scale score 0-2), death and symptomatic intracerebral hemorrhage (sICH) in MT for M2 segment occlusion in patients with AIS versus those of M1 segment or best medical care. RESULTS: Nine studies enrolling 2152 patients compared MT for patients with AIS of M2 segment occlusion and those of M1 segment occlusion. MT for M2 occlusion had a higher rate of 3-month functional independence compared to the patients with M1 occlusion. (RR 1.27, 95% CI 1.11-1.44, P < 0.001) and decreased death (RR 0.74; 95% CI 0.58-0.96, P = 0.022) with similar risk of sICH (RR 1.11; 95% CI 0.65-1.87, P = 0.707). Four studies enrolling 1016 patients compared MT and best medical care for patients with AIS of M2 occlusion. MT for M2 occlusion benefit more than best medical care on 3-month functional independence (RR 1.43, 95% CI 1.08-1.90, P = 0.011) and death (RR 0.46; 95% CI 0.22-0.96, P = 0.022) with similar risk of sICH (RR 1.65; 95% CI 0.66-4.13; P = 0.286). CONCLUSION: MT for M2 segment benefit patients with AIS on 3-month functional independence compared with that of M1 segment or medical care, without increasing the risk of sICH.
Authors: Thomas A Tomsick; Sharon D Yeatts; David S Liebeskind; Janice Carrozzella; Lydia Foster; Mayank Goyal; Ruediger von Kummer; Michael D Hill; Andrew M Demchuk; Tudor Jovin; Bernard Yan; Osama O Zaidat; Wouter Schonewille; Stefan Engelter; Renee Martin; Pooja Khatri; Judith Spilker; Yuko Y Palesch; Joseph P Broderick Journal: J Neurointerv Surg Date: 2014-10-23 Impact factor: 5.836