随机对照试验
荟萃分析
医学
缺血性中风
冲程(发动机)
内科学
缺血
工程类
机械工程
作者
Rami Z. Morsi,Mohamed Elfil,Hazem S. Ghaith,Mohammad Aladawi,Ahmed Elmashad,Sachin Kothari,Harsh Desai,Sherief Ghozy,Shyam Prabhakaran,Krishna Amuluru,Chirag D. Gandhi,Tareq Kass‐Hout,Fawaz Al‐Mufti
标识
DOI:10.1016/j.jns.2024.123003
摘要
Recent studies indicate endovascular thrombectomy (EVT) as a safe, effective treatment for acute ischemic stroke (AIS) with large ischemic regions. Our study updates an ongoing living systematic review and meta-analysis of randomized controlled trials (RCTs) comparing outcomes of EVT to medical management only.We searched MEDLINE, EMBASE, and the Cochrane Library for RCTs comparing EVT to medical management in AIS patients with large ischemic areas. Using fixed-effect models, we conducted a meta-analysis to compare functional independence, mortality, and symptomatic intracranial hemorrhage (sICH) between EVT and standard medical management. We evaluated bias risk with the Cochrane tool and graded the certainty of evidence using the GRADE approach.Of 1363 new citations, we included six RCTs with a total of 1876 patients. We found low-certainty evidence of improved functional independence (risk difference [RD] 29.9%, 95% CI 17.2% to 46.9%), increase in sICH (RD 2.6%, 95% CI 0.3% to 6.4%), and a non-significant decrease in mortality (RD -1.8%, 95% CI -3.9% to 0.6%) for AIS patients with large infarcts who underwent EVT compared to medical management only.Our revised meta-analysis suggests low-certainty evidence that there is improved functional independence, a non-significant decrease in mortality, and an increase in sICH among AIS patients with large infarcts who undergo EVT compared to those receiving medical management alone.PROSPERO (CRD42023398742).
科研通智能强力驱动
Strongly Powered by AbleSci AI