Endovascular treatment versus medical care alone for ischaemic stroke: systematic review and meta-analysis.
Bottom Line: Systematic review and meta-analysis.Heterogeneity was high among studies.Subgroup analysis of these seven studies yielded a risk ratio of 1.56 (95% confidence interval 1.38 to 1.75) for good functional outcomes and 0.86 (0.69 to 1.06) for mortality, without heterogeneity among the results of the studies.
Affiliation: Laboratory of Clinical Pharmacology and Therapeutics, Faculty of Medicine, University of Lisbon, Av Prof Egas Moniz 1649-035, Lisbon, Portugal Clinical Pharmacology Unit, Instituto de Medicina Molecular, Lisbon, Portugal Department of Medicine, Hospital de Santa Maria, Centro Hospitalar Lisboa Norte, Portugal firstname.lastname@example.org.Show MeSH
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Mentions: Electronic searches yielded 758 records after removal of duplicates. The interobserver agreement between screeners was good (Cohen’s κ coefficient 0.75, 95% confidence interval 0.56 to 0.93).16 Ten studies were included (fig 1); three published in 2013 (Interventional Management of Stroke (IMS) III Trial (IMS III), Intra-arterial Versus Systemic Thrombolysis for Acute Ischemic Stroke (SYNTHESIS Expansion), Mechanical Retrieval and Recanalization of Stroke Clots Using Embolectomy (MR RESCUE)),282930 five in 2015 (Endovascular treatment for acute ischemic stroke in the Netherlands (MR CLEAN), Endovascular Treatment for Small Core and Proximal Occlusion Ischemic Stroke (ESCAPE), Extending the Time for Thrombolysis in Emergency Neurological Deficits-Intra-Arterial (EXTEND-IA), Solitaire With the Intention For Thrombectomy as PRIMary Endovascular Treatment (SWIFT-PRIME), and Endovascular Revascularization With Solitaire Device Versus Best Medical Therapy in Anterior Circulation Stroke Within 8 Hours (REVASCAT)),3132333435 and two presented in 2015 but not yet published (Assess the Penumbra System in the Treatment of Acute Stroke (THERAPY) and Trial and Cost Effectiveness Evaluation of Intra-arterial Thrombectomy in Acute Ischemic Stroke (THRACE)).3637 When needed, we consulted the published protocols, supplementary material, and press releases of these studies.38394041424344454647 The principal investigators of THERAPY and THRACE were unsuccessfully contacted for data. Therefore, data extraction for these trials was based solely on results presented at scientific meetings and in press releases.
Affiliation: Laboratory of Clinical Pharmacology and Therapeutics, Faculty of Medicine, University of Lisbon, Av Prof Egas Moniz 1649-035, Lisbon, Portugal Clinical Pharmacology Unit, Instituto de Medicina Molecular, Lisbon, Portugal Department of Medicine, Hospital de Santa Maria, Centro Hospitalar Lisboa Norte, Portugal email@example.com.