Endovascular therapy versus no endovascular therapy in patients receiving best medical management for acute isolated occlusion of the posterior cerebral artery: A systematic review and meta-analysis
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Endovascular therapy versus no endovascular therapy in patients receiving best medical management for acute isolated occlusion of the posterior cerebral artery: A systematic review and meta-analysis. / Berberich, Anne; Finitsis, Stephanos; Strambo, Davide; Michel, Patrik; Herweh, Christian; Meyer, Lukas; Hanning, Uta; Strbian, Daniel; Abdalkader, Mohamad; Nogueira, Raul G; Puetz, Volker; Kaiser, Daniel P O; Olive-Gadea, Marta; Ribo, Marc; Fragata, Isabel; Marto, João Pedro; Romoli, Michele; Ringleb, Peter A; Nguyen, Thanh N; Nagel, Simon.
in: EUR J NEUROL, Jahrgang 29, Nr. 9, 09.2022, S. 2664-2673.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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T1 - Endovascular therapy versus no endovascular therapy in patients receiving best medical management for acute isolated occlusion of the posterior cerebral artery: A systematic review and meta-analysis
AU - Berberich, Anne
AU - Finitsis, Stephanos
AU - Strambo, Davide
AU - Michel, Patrik
AU - Herweh, Christian
AU - Meyer, Lukas
AU - Hanning, Uta
AU - Strbian, Daniel
AU - Abdalkader, Mohamad
AU - Nogueira, Raul G
AU - Puetz, Volker
AU - Kaiser, Daniel P O
AU - Olive-Gadea, Marta
AU - Ribo, Marc
AU - Fragata, Isabel
AU - Marto, João Pedro
AU - Romoli, Michele
AU - Ringleb, Peter A
AU - Nguyen, Thanh N
AU - Nagel, Simon
N1 - © 2022 The Authors. European Journal of Neurology published by John Wiley & Sons Ltd on behalf of European Academy of Neurology.
PY - 2022/9
Y1 - 2022/9
N2 - BACKGROUND AND PURPOSE: Endovascular therapy (EVT) is increasingly reported for treatment of isolated posterior cerebral artery (PCA) occlusions although its clinical benefit remains uncertain. This study-level meta-analysis investigated the functional outcomes and safety of EVT and best medical management (BMM) compared to BMM alone for treatment of PCA occlusion stroke.METHODS: We conducted a literature search in PubMed, Web of Science and Embase for studies in patients with isolated PCA occlusion stroke treated with EVT + BMM or BMM including intravenous thrombolysis. There were no randomized trials and all studies were retrospective. The primary outcome was modified Rankin Scale score of 0-2 at 3 months, while safety outcomes included mortality rate and incidence of symptomatic intracranial hemorrhage (sICH).RESULTS: Twelve studies with a total of 679 patients were included in the meta-analysis: 338 patients with EVT + BMM and 341 patients receiving BMM alone. Good functional outcome at 3 months was achieved in 58.0% (95% confidence interval [CI] 43.83-70.95) of patients receiving EVT + BMM and 48.1% (95% CI 40.35-55.92) of patients who received BMM alone, with respective mortality rates of 12.6% (95% CI 7.30-20.93) and 12.3% (95% CI 8.64-17.33). sICH occurred in 4.2% (95% CI 2.47-7.03) of patients treated with EVT + BMM and 3.2% (95% CI 1.75-5.92) of patients treated with BMM alone. Comparative analyses were performed on studies that included both treatments and these demonstrated no significant differences.CONCLUSIONS: Our results demonstrate that EVT represents a safe treatment for patients with isolated PCA occlusion stroke. There were no differences in clinical or safety outcomes between treatments, supporting randomization of future patients into distal vessel occlusion trials.
AB - BACKGROUND AND PURPOSE: Endovascular therapy (EVT) is increasingly reported for treatment of isolated posterior cerebral artery (PCA) occlusions although its clinical benefit remains uncertain. This study-level meta-analysis investigated the functional outcomes and safety of EVT and best medical management (BMM) compared to BMM alone for treatment of PCA occlusion stroke.METHODS: We conducted a literature search in PubMed, Web of Science and Embase for studies in patients with isolated PCA occlusion stroke treated with EVT + BMM or BMM including intravenous thrombolysis. There were no randomized trials and all studies were retrospective. The primary outcome was modified Rankin Scale score of 0-2 at 3 months, while safety outcomes included mortality rate and incidence of symptomatic intracranial hemorrhage (sICH).RESULTS: Twelve studies with a total of 679 patients were included in the meta-analysis: 338 patients with EVT + BMM and 341 patients receiving BMM alone. Good functional outcome at 3 months was achieved in 58.0% (95% confidence interval [CI] 43.83-70.95) of patients receiving EVT + BMM and 48.1% (95% CI 40.35-55.92) of patients who received BMM alone, with respective mortality rates of 12.6% (95% CI 7.30-20.93) and 12.3% (95% CI 8.64-17.33). sICH occurred in 4.2% (95% CI 2.47-7.03) of patients treated with EVT + BMM and 3.2% (95% CI 1.75-5.92) of patients treated with BMM alone. Comparative analyses were performed on studies that included both treatments and these demonstrated no significant differences.CONCLUSIONS: Our results demonstrate that EVT represents a safe treatment for patients with isolated PCA occlusion stroke. There were no differences in clinical or safety outcomes between treatments, supporting randomization of future patients into distal vessel occlusion trials.
U2 - 10.1111/ene.15410
DO - 10.1111/ene.15410
M3 - SCORING: Journal article
C2 - 35587104
VL - 29
SP - 2664
EP - 2673
JO - EUR J NEUROL
JF - EUR J NEUROL
SN - 1351-5101
IS - 9
ER -
