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Imaging-Based Patient Selection and Endovascular Therapy of Ischemic Stroke A Stratified Meta-Analysis
Zheng, Fanfan1; Xie, Wuxiang2; Wuxiang Xie
Source PublicationMEDICINE
2015-09-01
Volume94Issue:38Pages:1539
SubtypeReview
AbstractThe 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.
KeywordImaging Cta
WOS HeadingsScience & Technology ; Life Sciences & Biomedicine
DOI10.1097/MD.0000000000001539
WOS KeywordCEREBRAL-ARTERY STROKE ; RANDOMIZED-TRIAL ; SYSTEMATIC ANALYSIS ; CT ANGIOGRAPHY ; GLOBAL BURDEN ; DISEASE ; RECANALIZATION ; PROUROKINASE ; MANAGEMENT ; OCCLUSION
Indexed BySCI
Language英语
Funding OrganizationNational Natural Science Foundation of China(81302503)
WOS Research AreaGeneral & Internal Medicine
WOS SubjectMedicine, General & Internal
WOS IDWOS:000369533200016
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Document Type期刊论文
Identifierhttp://ir.ia.ac.cn/handle/173211/11337
Collection脑网络组研究中心
Corresponding AuthorWuxiang Xie
Affiliation1.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
Recommended Citation
GB/T 7714
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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