A systematic review of randomized controlled trials of endovascular therapy for stroke on mortality and disability.
J Neurol Sci
; 460: 122991, 2024 May 15.
Article
in En
| MEDLINE
| ID: mdl-38579415
ABSTRACT
BACKGROUND:
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.METHODS:
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.RESULTS:
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.CONCLUSIONS:
This meta-analysis suggests that EVT reduces both mortality and moderately severe or severe disability in patients with anterior circulation LVO stroke.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Randomized Controlled Trials as Topic
/
Endovascular Procedures
Limits:
Humans
Language:
En
Journal:
J Neurol Sci
Year:
2024
Document type:
Article
Affiliation country:
Canadá
Country of publication:
Países Bajos