Endovascular Thrombectomy for Anterior Circulation Stroke
What is the safety and efficacy of endovascular thrombectomy for stroke?
The investigators performed a meta-analysis of studies evaluating endovascular thrombectomy for stroke. They searched PubMed, Embase, Web of Science, SCOPUS, ClinicalTrials.gov, and Cochrane databases to identify original research published between 1996 and 2015 that reported clinical outcomes in patients for stroke at 90 days with the modified Rankin Scale. Two authors independently reviewed articles for inclusion.
Nine studies met the investigators’ inclusion criteria. Use of thrombectomy was associated with good outcome (odds ratio [OR], 1.75; 95% confidence interval [CI], 1.20-2.54). This benefit was preserved in multiple subgroups (younger patients: OR, 1.85; 95% CI, 1.50-2.28, older patients: OR, 1.93; 95% CI, 1.10-3.37), patients receiving intravenous thrombolysis (OR, 1.83; 95% CI, 1.46-2.31), patients not receiving intravenous thrombolysis (OR, 1.59; 95% CI, 0.86-2.95), patients with worse strokes (OR, 2.23; 95% CI, 1.56-3.18), and patients with more moderate strokes (OR, 1.72; 95% CI, 1.36-2.18). There was no difference in symptomatic intracranial hemorrhage and mortality between patients treated with thrombectomy and controls.
The authors concluded that endovascular thrombectomy is associated with improved outcome in patients presenting with anterior circulation stroke.
Endovascular thrombectomy using stent retrievers has been a major advance in the treatment of patients with anterior circulation stroke and is associated with marked improvements in clinical outcomes. These strong data invoke the need to develop coordinated systems of care to ensure rapid and widespread delivery of endovascular stroke treatment across communities.
< Back to Listings