Overview of systematic reviews comparing endovascular to best medical treatment for large-vessel occlusion acute ischaemic stroke: an umbrella review.

NIHSS endovascular treatment large-vessel occlusion meta-analysis modified Rankin scale mortality stroke symptomatic intracranial haemorrhage systematic review

Journal

Therapeutic advances in neurological disorders
ISSN: 1756-2856
Titre abrégé: Ther Adv Neurol Disord
Pays: England
ID NLM: 101480242

Informations de publication

Date de publication:
2024
Historique:
received: 16 11 2023
accepted: 26 03 2024
medline: 30 4 2024
pubmed: 30 4 2024
entrez: 30 4 2024
Statut: epublish

Résumé

The literature on endovascular treatment (EVT) for large-vessel occlusion (LVO) acute ischaemic stroke (AIS) has been rapidly increasing after the publication of positive randomized-controlled clinical trials (RCTs) and a plethora of systematic reviews (SRs) showing benefit compared to best medical therapy (BMT) for LVO. An overview of SRs (umbrella review) and meta-analysis of primary RCTs were performed to summarize the literature and present efficacy and safety of EVT. MEDLINE Three eligible SRs and 4 additional RCTs were included in the overview, comprising a total of 24 RCTs, corresponding to 5968 AIS patients with LVO (3044 randomized to EVT In patients with AIS due to LVO in the anterior or posterior circulation, within 24 h from symptom onset, EVT improves functional outcomes and increases the chance of survival despite increased sICH risk. PROSPERO Registration Number CRD42023461138.

Sections du résumé

Background UNASSIGNED
The literature on endovascular treatment (EVT) for large-vessel occlusion (LVO) acute ischaemic stroke (AIS) has been rapidly increasing after the publication of positive randomized-controlled clinical trials (RCTs) and a plethora of systematic reviews (SRs) showing benefit compared to best medical therapy (BMT) for LVO.
Objectives UNASSIGNED
An overview of SRs (umbrella review) and meta-analysis of primary RCTs were performed to summarize the literature and present efficacy and safety of EVT.
Design and methods UNASSIGNED
MEDLINE
Results UNASSIGNED
Three eligible SRs and 4 additional RCTs were included in the overview, comprising a total of 24 RCTs, corresponding to 5968 AIS patients with LVO (3044 randomized to EVT
Conclusion UNASSIGNED
In patients with AIS due to LVO in the anterior or posterior circulation, within 24 h from symptom onset, EVT improves functional outcomes and increases the chance of survival despite increased sICH risk.
Registration UNASSIGNED
PROSPERO Registration Number CRD42023461138.

Identifiants

pubmed: 38685935
doi: 10.1177/17562864241246938
pii: 10.1177_17562864241246938
pmc: PMC11057347
doi:

Types de publication

Journal Article Review

Langues

eng

Pagination

17562864241246938

Informations de copyright

© The Author(s), 2024.

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Auteurs

Apostolos Safouris (A)

Stroke Unit, Metropolitan Hospital, Piraeus, Greece.
Second Department of Neurology, 'Attikon' University Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.

Lina Palaiodimou (L)

Second Department of Neurology, 'Attikon' University Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.

Aristeidis H Katsanos (AH)

Division of Neurology, McMaster University and Population Health Research Institute, Hamilton, ON, Canada.

Odysseas Kargiotis (O)

Stroke Unit, Metropolitan Hospital, Piraeus, Greece.

Konstantinos I Bougioukas (KI)

Department of Hygiene, Social-Preventive Medicine and Medical Statistics, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece.

Klearchos Psychogios (K)

Stroke Unit, Metropolitan Hospital, Piraeus, Greece.
Second Department of Neurology, 'Attikon' University Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.

Tatiana Sidiropoulou (T)

Second Department of Anesthesiology, 'Attikon' University Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.

Stavros Spiliopoulos (S)

Interventional Radiology Unit, Second Department of Radiology, 'Attikon' University General Hospital, Athens, Greece.

Marios-Nikos Psychogios (MN)

Department of Neuroradiology, Clinic for Radiology and Nuclear Medicine, University Hospital Basel, Basel, Switzerland.

Georgios Magoufis (G)

Second Department of Neurology, 'Attikon' University Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.
Department of Interventional Neuroradiology, Metropolitan Hospital, Piraeus, Greece.

Guillaume Turc (G)

Department of Neurology, GHU Paris Psychiatrie et Neurosciences, Paris, France.
Department of Neurology, Université Paris Cité, Paris, France.
Institute of Psychiatry and Neuroscience of Paris, INSERM U1266, Paris, France.
Department of Neurology, FHU NeuroVasc, Paris, France.

Georgios Tsivgoulis (G)

Second Department of Neurology, 'Attikon' University Hospital, School of Medicine, National and Kapodistrian University of Athens, Rimini 1, Chaidari, Athens 12462, Greece.

Classifications MeSH