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Imaging-Based Patient Selection and Endovascular Therapy of Ischemic Stroke A Stratified Meta-Analysis
Zheng, Fanfan1; Xie, Wuxiang2; Wuxiang Xie
2015-09-01
发表期刊MEDICINE
卷号94期号:38页码:1539
文章类型Review
摘要The positive results of recent trials for the treatment of acute ischemic stroke have highlighted the importance of imaging selection before endovascular therapy. We performed a stratified meta-analysis to confirm this new understanding.We searched EMBASE, PubMed, Cochrane Central Register of Controlled Trials, and ClinicalTrials.gov in April 2015 for randomized controlled trials evaluating the effect of endovascular treatment in patients with acute ischemic stroke. The meta-analysis was stratified by whether computed tomographic angiography (CTA) was used to select patients. Outcome data were pooled using fixed-effects models.Seven randomized controlled trials with 2217 patients were included in this study. Endovascular therapy significantly increased the rate of 90-day functional independence (a modified Rankin score of 0-2) in patients with a CTA-confirmed large-vessel occlusion (relative risk [RR] = 1.75, 95% confidence interval [CI]: 1.48-2.06, I-2=0.0%), and reduced 90-day mortality in patients with occlusion stroke with a small ischemic core (RR=0.58, 95% CI: 0.37-0.89, I-2=0.0%). The functional benefit was significantly greater in patients with CTA-based selection than in those without (Z=5.04, P<0.001). The mortality benefit was significantly greater in patients with a large-vessel occlusion and a small ischemic core than in those without CTA-based selection (Z=2.04, P=0.041). There was no evidence of between-study heterogeneity or publication bias.This meta-analysis showed the effect of vascular imaging on identifying patients with acute ischemic stroke with a proximal vessel occlusion and a small ischemic core, who would benefit from endovascular therapy.
关键词Imaging Cta
WOS标题词Science & Technology ; Life Sciences & Biomedicine
DOI10.1097/MD.0000000000001539
关键词[WOS]CEREBRAL-ARTERY STROKE ; RANDOMIZED-TRIAL ; SYSTEMATIC ANALYSIS ; CT ANGIOGRAPHY ; GLOBAL BURDEN ; DISEASE ; RECANALIZATION ; PROUROKINASE ; MANAGEMENT ; OCCLUSION
收录类别SCI
语种英语
项目资助者National Natural Science Foundation of China(81302503)
WOS研究方向General & Internal Medicine
WOS类目Medicine, General & Internal
WOS记录号WOS:000369533200016
引用统计
文献类型期刊论文
条目标识符http://ir.ia.ac.cn/handle/173211/11337
专题脑网络组研究中心
通讯作者Wuxiang Xie
作者单位1.Chinese Acad Sci, Brainnetome Ctr, Inst Automat, Beijing, Peoples R China
2.Capital Med Univ, Beijing Inst Heart Lung & Blood Vessel Dis, Beijing Anzhen Hosp, Dept Epidemiol, 2 Anzhen St, Beijing 100029, Peoples R China
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Zheng, Fanfan,Xie, Wuxiang,Wuxiang Xie. Imaging-Based Patient Selection and Endovascular Therapy of Ischemic Stroke A Stratified Meta-Analysis[J]. MEDICINE,2015,94(38):1539.
APA Zheng, Fanfan,Xie, Wuxiang,&Wuxiang Xie.(2015).Imaging-Based Patient Selection and Endovascular Therapy of Ischemic Stroke A Stratified Meta-Analysis.MEDICINE,94(38),1539.
MLA Zheng, Fanfan,et al."Imaging-Based Patient Selection and Endovascular Therapy of Ischemic Stroke A Stratified Meta-Analysis".MEDICINE 94.38(2015):1539.
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