Endovascular Treatment for Acute Basilar Artery Occlusion: A Fragility Index Meta-Analysis.
acute basilar artery occlusion
acute ischemic stroke
basilar stroke
endovascular treatment
mechanical thrombectomy
meta-analysis
posterior circulation
randomized controlled clinical trials
Journal
Journal of clinical medicine
ISSN: 2077-0383
Titre abrégé: J Clin Med
Pays: Switzerland
ID NLM: 101606588
Informations de publication
Date de publication:
30 Mar 2023
30 Mar 2023
Historique:
received:
03
03
2023
revised:
22
03
2023
accepted:
28
03
2023
medline:
14
4
2023
entrez:
13
4
2023
pubmed:
14
4
2023
Statut:
epublish
Résumé
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). 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. 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; I 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.
Identifiants
pubmed: 37048699
pii: jcm12072617
doi: 10.3390/jcm12072617
pmc: PMC10094975
pii:
doi:
Types de publication
Journal Article
Review
Langues
eng
Références
J Neurosurg. 2023 Feb 3;:1-9
pubmed: 36738467
AJNR Am J Neuroradiol. 2021 May;42(5):896-903
pubmed: 33664106
N Engl J Med. 2022 Oct 13;387(15):1361-1372
pubmed: 36239644
J Stroke. 2023 Jan;25(1):81-91
pubmed: 36746382
Brain Behav. 2016 Jan 07;6(2):e00418
pubmed: 27110444
Lancet Neurol. 2018 Oct;17(10):895-904
pubmed: 30264728
J Neurointerv Surg. 2022 Dec;14(12):1173-1179
pubmed: 35387858
BMJ. 2019 Aug 28;366:l4898
pubmed: 31462531
Stroke. 2022 Jun;53(6):2069-2074
pubmed: 35543129
PLoS One. 2022 Aug 17;17(8):e0273103
pubmed: 35976963
J Clin Epidemiol. 2021 Jun;134:103-112
pubmed: 33577987
Stroke Vasc Neurol. 2023 Feb;8(1):1-3
pubmed: 36219568
Biom J. 2020 Jan;62(1):69-98
pubmed: 31553488
JAMA Neurol. 2020 May 1;77(5):561-573
pubmed: 32080711
Circulation. 2022 Jul 5;146(1):6-17
pubmed: 35656816
BMC Neurol. 2022 Nov 9;22(1):415
pubmed: 36352362
Contemp Clin Trials. 2015 Nov;45(Pt A):139-45
pubmed: 26343745
N Engl J Med. 2018 Feb 22;378(8):708-718
pubmed: 29364767
Eur J Neurol. 2021 Jun;28(6):2106-2110
pubmed: 33482047
N Engl J Med. 2022 Oct 13;387(15):1373-1384
pubmed: 36239645
Lancet Neurol. 2009 Aug;8(8):724-30
pubmed: 19577962
J Stroke Cerebrovasc Dis. 2022 Dec;31(12):106847
pubmed: 36323166
Ann Neurol. 2015 Mar;77(3):415-24
pubmed: 25516154
N Engl J Med. 2022 Oct 13;387(15):1428-1429
pubmed: 36239649
Stroke. 2020 Oct;51(10):3182-3186
pubmed: 32912092
Stroke. 2022 Jan;53(1):e9-e13
pubmed: 34753305
Life (Basel). 2021 May 15;11(5):
pubmed: 34063551
Stroke. 2017 Dec;48(12):3252-3257
pubmed: 29089457
J Stroke. 2022 Jan;24(1):3-20
pubmed: 35135056
N Engl J Med. 2021 May 20;384(20):1910-1920
pubmed: 34010530
Neurology. 2021 Nov 16;97(20 Suppl 2):S126-S136
pubmed: 34785611
AJNR Am J Neuroradiol. 2017 Aug;38(8):1600-1604
pubmed: 28546252
Eur J Intern Med. 2023 Apr;110:22-28
pubmed: 36572580
BMJ. 1997 Sep 13;315(7109):629-34
pubmed: 9310563
Stroke. 2018 Nov;49(11):2728-2732
pubmed: 30355215
N Engl J Med. 2018 Jan 4;378(1):11-21
pubmed: 29129157
Stroke. 2022 Mar;53(3):758-768
pubmed: 34753304
Ann Neurol. 2013 Jun;73(6):688-94
pubmed: 23536323
Clin Neuroradiol. 2022 Dec 2;:
pubmed: 36459175
Lancet Neurol. 2020 Feb;19(2):115-122
pubmed: 31831388
Stroke. 2019 Dec;50(12):e344-e418
pubmed: 31662037
Prev Sci. 2013 Apr;14(2):134-43
pubmed: 23479191
Eur Stroke J. 2019 Mar;4(1):6-12
pubmed: 31165090