Endovascular Treatment with Intravenous Thrombolysis versus Endovascular Treatment Alone for Acute Anterior Circulation Stroke : A Meta-Analysis of Observational Studies
10.3340/jkns.2017.0505.006
- Author:
Chul Ho KIM
1
;
Jin Pyeong JEON
;
Sung Eun KIM
;
Hyuk Jai CHOI
;
Yong Jun CHO
Author Information
1. Department of Neurology, Hallym University College of Medicine, Chuncheon, Korea.
- Publication Type:Meta-Analysis
- Keywords:
Thrombectomy;
Stroke;
Endovascular procedures;
Mechanical thrombolysis
- MeSH:
Angiography;
Endovascular Procedures;
Humans;
Intracranial Hemorrhages;
Mechanical Thrombolysis;
Mortality;
Population Characteristics;
Publication Bias;
Stroke;
Thrombectomy
- From:Journal of Korean Neurosurgical Society
2018;61(4):467-473
- CountryRepublic of Korea
- Language:English
-
Abstract:
OBJECTIVE: The aim of this study was to determine outcome of ischemic stroke patients in the anterior circulation treated with endovascular treatment (EVT) with intravenous thrombolysis (IVT) versus EVT alone group.METHODS: A systemic literature review was performed using online database from January 2004 to January 2017. Primary outcomes were successful recanalization seen on finial angiography and good outcome at three months. Secondary outcomes were mortality and the development of symptomatic intracranial hemorrhage (S-ICH) after the procedure. A fixed effect model was used when heterogeneity was less than 50%. Egger’s regression test was used to assess publication bias.RESULTS: Five studies were included for final analysis. Between EVT with IVT and EVT alone group, successful recanalization (odds ratio [OR] 1.467, p=0.216), good clinical outcome at three months (OR 1.199, p=0.385), mortality (OR 0.776, p=0.371), and S-ICH (OR 1.820, p=0.280) did not differ significantly. Egger’s regression intercept with 95% confidence interval (CI) was 1.99 (95% CI -2.91 to 6.89) in successful recanalization and -0.27 (95% CI -6.35 to 5.80) in good clinical outcome, respectively.CONCLUSION: The two treatment modalities, EVT with IVT and EVT alone, could be comparable in treating acute anterior circulation stroke. Studies to find specific beneficiary group for EVT alone, without primary IVT, are needed further.
