التفاصيل البيبلوغرافية
| العنوان: |
Endovascular Treatment for Acute Basilar Artery Occlusion: A Fragility Index Meta-Analysis |
| المؤلفون: |
Lina Palaiodimou, Andreas Eleftheriou, Aristeidis H. Katsanos, Apostolos Safouris, Georgios Magoufis, Stavros Spiliopoulos, Georgios Velonakis, Sofia Vassilopoulou, Diana Aguiar de Sousa, Guillaume Turc, Daniel Strbian, Georgios Tsivgoulis |
| المصدر: |
Journal of Clinical Medicine; Volume 12; Issue 7; Pages: 2617 |
| بيانات النشر: |
Multidisciplinary Digital Publishing Institute |
| سنة النشر: |
2023 |
| المجموعة: |
MDPI Open Access Publishing |
| مصطلحات موضوعية: |
acute ischemic stroke, acute basilar artery occlusion, endovascular treatment, mechanical thrombectomy, basilar stroke, posterior circulation, meta-analysis, randomized controlled clinical trials |
| الوصف: |
Introduction: High-quality evidence regarding the use of endovascular treatment (EVT) in patients with acute basilar artery occlusion (BAO) has been provided by recently completed randomized controlled clinical trials (RCTs). Methods: We conducted a systematic review and meta-analysis including all available RCTs that investigated efficacy and safety of EVT in addition to best medical treatment (BMT) versus BMT alone for BAO. The random-effects model was used, while the fragility index (FI) was calculated for dichotomous outcomes of interest. Results: Four RCTs were included comprising a total of 988 patients with acute BAO (mean age: 65.6 years, 70% men, median NIHSS: 24, 39% pretreatment with intravenous thrombolysis). EVT was related to higher likelihood of good functional outcome (RR: 1.54; 95% CI: 1.16–2.05; I2 = 60%), functional independence (RR: 1.83; 95% CI: 1.08–3.08; I2 = 79%) and reduced disability at 3 months (adjusted common OR: 1.96; 95% CI: 1.26–3.05; I2 = 59%) compared to BMT alone. Despite that EVT was associated with a higher risk for symptomatic intracranial hemorrhage (RR: 7.78; 95% CI: 2.36–25.61; I2 = 0%) and any intracranial hemorrhage (RR: 2.85; 95% CI: 1.50–5.44; I2 = 16%), mortality at 3 months was lower among patients that received EVT plus BMT versus BMT alone (RR: 0.76; 95% CI: 0.65–0.89; I2 = 0%). However, sufficient robustness was not evident in any of the reported associations (FI < 10) including the overall effect regarding the primary outcome. The former associations were predominantly driven by RCTs with recruitment limited in China. Conclusions: EVT combined with BMT is associated with a higher likelihood of achieving good functional outcomes and a lower risk of death at 3 months compared to BMT alone, despite the higher risk of sICH. An individual-patient data meta-analysis is warranted to uncover and adjust for potential sources of heterogeneity and to provide further insight. |
| نوع الوثيقة: |
text |
| وصف الملف: |
application/pdf |
| اللغة: |
English |
| العلاقة: |
Clinical Neurology; https://dx.doi.org/10.3390/jcm12072617Test |
| DOI: |
10.3390/jcm12072617 |
| الإتاحة: |
https://doi.org/10.3390/jcm12072617Test |
| حقوق: |
https://creativecommons.org/licenses/by/4.0Test/ |
| رقم الانضمام: |
edsbas.36FC9D2A |
| قاعدة البيانات: |
BASE |
