SynthesisSystematic reviews2024
Endovascular thrombectomy after anterior circulation large vessel ischemic stroke: an updated meta-analysis.
Synthesis in Systematic reviews, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed.
- Tenecteplase vs. alteplase for ischemic stroke beyond 4.5 hours: a network meta-analysis of randomized controlled trials.Journal of thrombosis and thrombolysis · 2026Article
- Time-dependent efficacy and safety of endovascular treatment in anterior circulation stroke: A systematic review and meta-analysis.Journal of thrombosis and thrombolysis · 2026Review
- The inflammation-fibrosis combined index as a predictor of prognosis in stroke patients undergoing mechanical thrombectomy.Frontiers in aging neuroscience · 2026Article
- Advances in Ischemic Stroke Treatment: Current and Future Therapies.Neurology and therapy · 2025Review
- Assessment of cerebral hemodynamic changes in acute ischemic stroke patients following mechanical thrombectomy using CT perfusion imaging.Frontiers in neurology · 2025Article
- Effect of early neuroendovascular team involvement in acute stroke protocol: a retrospective study.Frontiers in neurology · 2025Article
- Development of a novel nomogram to predict hemorrhagic transformation following endovascular treatment in patients with acute ischemic stroke.Frontiers in neurology · 2025Article
- Association of infarct volume with early neurological deterioration in ischemic stroke patients undergoing endovascular treatment.Frontiers in neurologyArticle
Corrections and comments
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Authors and funding
10 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundEndovascular thrombectomy (EVT) has emerged as the established standard of care for the treatment of anterior circulation large-vessel occlusion (LVO). However, its benefits remain unclear in specific patient populations. Herein, we present an updated systematic review and meta-analysis aimed at thoroughly assessing the effectiveness and safety of combining EVT with medical treatment (MT) compared with MT alone.
methodsThis systematic review was performed in accordance with the PRISMA guideline. The MEDLINE, Embase, and Cochrane databases were systematically searched to identify relevant articles published until December 30, 2023. The inclusion criteria restricted articles to randomized clinical trials (RCTs). We pooled odds ratios (OR) and their respective 95% confidence intervals (CIs).
resultsFifteen RCTs involving 3897 patients were included in the study. EVT plus MT was associated with a significant reduction in disability at 90 days (OR = 1.91, [1.61-2.26]), improved functional independence (modified Rankin Scale [mRS] 0-2) (OR = 2.19 [1.81-2.64]), excellent functional outcomes (mRS 0-1) (OR = 2.37, [1.45-3.87]), improved independent ambulation (mRS 0-3) (OR = 2.17, [1.75-2.69]), and higher rates of partial/complete recanalization (OR = 2.18, [1.66-2.87] compared with EVT. Efficacy outcomes for both large and small infarct cores were statistically favorable following EVT. Safety outcomes showed comparable rates, except for intracerebral and subarachnoid hemorrhage, which favored MT alone.
conclusionThis meta-analysis supports the use of EVT plus MT as the standard of care for acute ischemic stroke patients with LVO of any infarct core size, as it offers substantial improvements in functional outcomes and recanalization. Safety considerations, particularly the risk of hemorrhage, warrant careful patient selection. These findings provide valuable insights for optimizing stroke management protocols and enhancing patient outcomes.
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