Affiliated ZhongDa Hospital, School of Medicine, Southeast University, China
Neurology

Presenter Of 1 Presentation

ENDOVASCULAR TREATMENT WITH AND WITHOUT INTRAVENOUS THROMBOLYSIS IN LARGE VESSEL OCCLUSIONS STROKE:A SYSTEMATIC REVIEW AND META-ANALYSIS

Session Type
Free Communication Session
Date
28.10.2021, Thursday
Session Time
08:00 - 09:30
Room
FREE COMMUNICATIONS A
Lecture Time
08:50 - 09:00

Abstract

Background and Aims

Previous studies showed conflicting results in the benefits of pretreatment with IVT before endovascular treatment (EVT) for acute ischemic stroke (AIS) patients with large vessel occlusions (LVOs). The aim of this study was to investigate the clinical efficacy and safety of EVT alone versus bridging therapy (BT) in AIS with LVOs.

Methods

A systematic review and meta-analysis of all available studies evaluating clinical outcomes between BT and EVT alone were conducted by electronic searching the NCBI/NLM PubMed and Web of Science database from inception to October 20, 2020. Primary outcomes focus on 90 days good outcome and mortality. Secondary outcomes included successful reperfusion, and sICH. The random-effect model was applied if P<0.10 for Cochran’s Q test or I2>50% for Higgins I2 statistics, otherwise the fixed-effect model was performed.

Results

A total of 93 studies enrolling 45,190 patients were admitted in present analysis. In both unadjusted and adjusted analysis, BT was associated with a higher likelihood of 90 days good outcome (crude odds ratio [cOR] 1.361, 95%CI 1.234-1.502 and adjusted OR[aOR] 1.369, 95%CI 1.217-1.540), successful reperfusion (cOR 1.271, 95%CI 1.149-1.406 and aOR 1.267, 95%CI 1.095-1.465) and lower odds of 90 days mortality (cOR 0.619, 95%CI 0.560-0.684 and aOR 0.718, 95%CI 0.594-0.868) compared with EVT alone. The two groups did not differ in sICH (cOR 1.062, 95%CI 0.915-1.232 and aOR 1.20, 95%CI 0.95-1.47) after evaluating by sensitivity analyses and adjusting for publication bias.

Conclusions

BT benefited more in clinical outcome without increasing the risk of safety compared with EVT alone in AIS patients with LVOs.

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