Journal article
Reocclusion after successful endovascular treatment in acute ischemic stroke: systematic review and meta-analysis
Journal of neurointerventional surgery, Vol.15(10), pp.964-970
10/2023
DOI: 10.1136/jnis-2022-019382
PMID: 36328479
Abstract
BackgroundEndovascular treatment (EVT) is the standard of care for selected patients with acute ischemic stroke (AIS) due to large vessel occlusion (LVO).ObjectiveTo systematically review the available data on: (1) incidence, predictors, and outcomes of patients with reocclusion after successful EVT for AIS and, (2) the characteristics, complications, and outcomes of patients with reocclusion treated with repeated EVT (rEVT) within 30 days of the first procedure.MethodsPubMed was searched (between January 2012 and April 2021) to identify studies reporting reocclusion following successful EVT (Thrombolysis in Cerebral Infarction ≥2b) in patients with AIS due to LVO. Pooled incidence of reocclusion per 100 patients with successful recanalization following EVT was calculated using a random-effects model with Freeman-Tukey double arcsine transformation. Extracted incidences of reocclusion according to etiology and use of intravenous thrombolysis were pooled using random-effects meta-analytic models.ResultsA total of 840 studies was identified and seven studies qualified for the quantitative analysis, which described 91 same-vessel reocclusions occurring within the first 7 days after treatment among 2067 patients (4.9%; 95% CI 3% to 7%, I2=70.2%). Large vessel atherosclerosis was associated with an increased risk of reocclusion (OR=3.44, 95% CI 1.12 to 10.61, I2=50%). We identified 90 patients treated with rEVT for recurrent LVO, described in five studies. The rates of procedural complications, mortality, and unfavorable functional outcome at 3 months were 18.0%, 18.9%, and 60.3%, respectively.ConclusionIn cohorts of patients with AIS due to LVO, 5% of patients experienced reocclusion within 7 days after successful EVT. Repeated EVT can be a safe and effective treatment for selected patients with reocclusion.
Details
- Title: Subtitle
- Reocclusion after successful endovascular treatment in acute ischemic stroke: systematic review and meta-analysis
- Creators
- Renato Oliveira - Hospital da LuzManuel A Correia - Department of Neuroradiology, Centro Hospitalar Universitário de Lisboa Norte, Lisbon, PortugalJoão Pedro Marto - Department of Neurology, Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Lisboa, Lisboa, PortugalMariana Carvalho Dias - Department of Neurology, Centro Hospitalar Universitário de Lisboa Norte, Lisbon, PortugalGhada A Mohamed - Department of Neurology, Medical University of South Carolina (MUSC), Charleston, South Carolina, USAThanh N Nguyen - Department of Neurology, Boston Medical Center, Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts, USARaul G Nogueira - Stroke Institute, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USAHassan Aboul-Nour - Department of Neurology, Emory University Hospitals, Atlanta, Georgia, USAHoria Marin - Department of Radiology, Henry Ford Health, Detroit, Michigan, USAAlex Bou Chebl - Department of Neurology, Henry Ford Hospital, Detroit, Michigan, USAMahmoud H Mohammaden - Department of Neurology, Emory University Atlanta, Atlanta, Georgia, USAAlhamza R Al-Bayati - Stroke Institute, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USADiogo C Haussen - Department of Neurology and Radiology, Emory University School of Medicine, Atlanta, Georgia, USAMohamad Abdalkader - Department of Radiology, Boston Medical Center, Boston, Massachusetts, USAJohanna T Fifi - Departments of Neurology and Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, New York, USASantiago Ortega-Gutierrez - Department of Neurology, Neurosurgery and Radiology, The University of Iowa Hospitals and Clinics, Iowa City, Iowa, USADileep R Yavagal - Department of Neurology and Neurosurgery, University of Miami, Miami, Florida, USAStephan A. Mayer - Department of Neurosurgery, Westchester Medical Center, Valhalla, New York, USAGeorgios Tsivgoulis - Second Department of Neurology, “Attikon” University Hospital, School of Medicine, National & Kapodistrian University of Athens, Athens, GreeceLia Lucas Neto - Institute of Anatomy, Faculdade de Medicina da Universidade de Lisboa, Lisboa, PortugalDiana Aguiar de Sousa - Stroke Center, Lisbon Central University Hospital, Lisbon, Portugal
- Resource Type
- Journal article
- Publication Details
- Journal of neurointerventional surgery, Vol.15(10), pp.964-970
- DOI
- 10.1136/jnis-2022-019382
- PMID
- 36328479
- NLM abbreviation
- J Neurointerv Surg
- ISSN
- 1759-8478
- eISSN
- 1759-8486
- Publisher
- BMJ Publishing Group Ltd
- Language
- English
- Electronic publication date
- 11/03/2022
- Date published
- 10/2023
- Academic Unit
- Neurology; Radiology; Iowa Neuroscience Institute; Neurosurgery
- Record Identifier
- 9984310140902771
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