Bridging therapy improves functional outcomes and reduces 90-day mortality compared with direct endovascular thrombectomy in patients with acute posterior ischemic stroke: a systematic review and meta-analysis.
Saved in:
| Title: | Bridging therapy improves functional outcomes and reduces 90-day mortality compared with direct endovascular thrombectomy in patients with acute posterior ischemic stroke: a systematic review and meta-analysis. |
|---|---|
| Authors: | Chen, Huiru (AUTHOR), Qiu, Youjia (AUTHOR), Wang, Zilan (AUTHOR), Teng, Haiying (AUTHOR), Chen, Zhouqing (AUTHOR), Kong, Yan (AUTHOR), Wang, Zhong (AUTHOR) |
| Source: | Neurological Sciences. Feb2024, Vol. 45 Issue 2, p495-506. 12p. |
| Subjects: | Stroke patients, Endovascular surgery, Basilar artery, Functional status, Intracranial hemorrhage, Ischemic stroke |
| Abstract: | Background: It remains unclear whether bridging therapy can achieve better neurologic outcomes than direct endovascular thrombectomy (EVT) in patients with posterior ischemic stroke. Methods: We systematically searched PubMed, EMBASE, and Cochrane databases with posterior artery occlusion treated with bridging therapy vs. EVT. Efficacy was assessed based on functional independence at 90 days and successful recanalization, whereas safety was assessed by mortality, rate of symptomatic intracranial hemorrhage (sICH), and occurrence of any hemorrhage. All data were analyzed with Review Manager software v5.3 and the risk of bias was determined using the Methodological Index for Non-randomized Studies. Results: We included 17 studies with a total of 3278 patients (1211 in the bridging therapy group and 2067 in the EVT group). Patients in the bridging group had a better functional outcome at 90 days, as evidenced by a higher proportion with a Modified Rankin Scale (mRS) score of 0–2 compared with the EVT group (odds ratio (OR) = 1.83, 95% confidence interval (CI): 1.54–2.19, P < 0.01), while no difference in mRS score of 0–3 (OR = 1.18, 95% CI: 0.96–1.45, P = 0.11). Patients in the bridging therapy group also had lower 90-day mortality rate (OR = 0.75, 95% CI: 0.59–0.95, P = 0.02). There were no significant differences between groups in rates of successful recanalization (OR = 0.96, 95% CI: 0.74–1.25, P = 0.77), sICH (OR = 1.27, 95% CI: 0.86–1.89, P = 0.24), and hemorrhage (OR = 1.22, 95% CI: 0.60–2.50, P = 0.58). Conclusions: Among patients with posterior ischemic stroke, bridging therapy may be superior to EVT in achieving a good functional outcome and lowering the mortality without increasing the risks of hemorrhage. [ABSTRACT FROM AUTHOR] |
| Copyright of Neurological Sciences is the property of Springer Nature and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.) | |
| Database: | Psychology and Behavioral Sciences Collection |
|
Full text is not displayed to guests.
Login for full access.
|
|
| FullText | Links: – Type: pdflink Text: Availability: 1 |
|---|---|
| Header | DbId: pbh DbLabel: Psychology and Behavioral Sciences Collection An: 174819437 AccessLevel: 6 PubType: Academic Journal PubTypeId: academicJournal PreciseRelevancyScore: 0 |
| IllustrationInfo | |
| Items | – Name: Title Label: Title Group: Ti Data: Bridging therapy improves functional outcomes and reduces 90-day mortality compared with direct endovascular thrombectomy in patients with acute posterior ischemic stroke: a systematic review and meta-analysis. – Name: Author Label: Authors Group: Au Data: <searchLink fieldCode="AR" term="%22Chen%2C+Huiru%22">Chen, Huiru</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Qiu%2C+Youjia%22">Qiu, Youjia</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Wang%2C+Zilan%22">Wang, Zilan</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Teng%2C+Haiying%22">Teng, Haiying</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Chen%2C+Zhouqing%22">Chen, Zhouqing</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Kong%2C+Yan%22">Kong, Yan</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Wang%2C+Zhong%22">Wang, Zhong</searchLink> (AUTHOR) – Name: TitleSource Label: Source Group: Src Data: <searchLink fieldCode="JN" term="%22Neurological+Sciences%22">Neurological Sciences</searchLink>. Feb2024, Vol. 45 Issue 2, p495-506. 12p. – Name: Subject Label: Subjects Group: Su Data: <searchLink fieldCode="DE" term="%22Stroke+patients%22">Stroke patients</searchLink><br /><searchLink fieldCode="DE" term="%22Endovascular+surgery%22">Endovascular surgery</searchLink><br /><searchLink fieldCode="DE" term="%22Basilar+artery%22">Basilar artery</searchLink><br /><searchLink fieldCode="DE" term="%22Functional+status%22">Functional status</searchLink><br /><searchLink fieldCode="DE" term="%22Intracranial+hemorrhage%22">Intracranial hemorrhage</searchLink><br /><searchLink fieldCode="DE" term="%22Ischemic+stroke%22">Ischemic stroke</searchLink> – Name: Abstract Label: Abstract Group: Ab Data: Background: It remains unclear whether bridging therapy can achieve better neurologic outcomes than direct endovascular thrombectomy (EVT) in patients with posterior ischemic stroke. Methods: We systematically searched PubMed, EMBASE, and Cochrane databases with posterior artery occlusion treated with bridging therapy vs. EVT. Efficacy was assessed based on functional independence at 90 days and successful recanalization, whereas safety was assessed by mortality, rate of symptomatic intracranial hemorrhage (sICH), and occurrence of any hemorrhage. All data were analyzed with Review Manager software v5.3 and the risk of bias was determined using the Methodological Index for Non-randomized Studies. Results: We included 17 studies with a total of 3278 patients (1211 in the bridging therapy group and 2067 in the EVT group). Patients in the bridging group had a better functional outcome at 90 days, as evidenced by a higher proportion with a Modified Rankin Scale (mRS) score of 0–2 compared with the EVT group (odds ratio (OR) = 1.83, 95% confidence interval (CI): 1.54–2.19, P < 0.01), while no difference in mRS score of 0–3 (OR = 1.18, 95% CI: 0.96–1.45, P = 0.11). Patients in the bridging therapy group also had lower 90-day mortality rate (OR = 0.75, 95% CI: 0.59–0.95, P = 0.02). There were no significant differences between groups in rates of successful recanalization (OR = 0.96, 95% CI: 0.74–1.25, P = 0.77), sICH (OR = 1.27, 95% CI: 0.86–1.89, P = 0.24), and hemorrhage (OR = 1.22, 95% CI: 0.60–2.50, P = 0.58). Conclusions: Among patients with posterior ischemic stroke, bridging therapy may be superior to EVT in achieving a good functional outcome and lowering the mortality without increasing the risks of hemorrhage. [ABSTRACT FROM AUTHOR] – Name: AbstractSuppliedCopyright Label: Group: Ab Data: <i>Copyright of Neurological Sciences is the property of Springer Nature and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.) |
| PLink | https://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=pbh&AN=174819437 |
| RecordInfo | BibRecord: BibEntity: Identifiers: – Type: doi Value: 10.1007/s10072-023-07096-x Languages: – Code: eng Text: English PhysicalDescription: Pagination: PageCount: 12 StartPage: 495 Subjects: – SubjectFull: Stroke patients Type: general – SubjectFull: Endovascular surgery Type: general – SubjectFull: Basilar artery Type: general – SubjectFull: Functional status Type: general – SubjectFull: Intracranial hemorrhage Type: general – SubjectFull: Ischemic stroke Type: general Titles: – TitleFull: Bridging therapy improves functional outcomes and reduces 90-day mortality compared with direct endovascular thrombectomy in patients with acute posterior ischemic stroke: a systematic review and meta-analysis. Type: main BibRelationships: HasContributorRelationships: – PersonEntity: Name: NameFull: Chen, Huiru – PersonEntity: Name: NameFull: Qiu, Youjia – PersonEntity: Name: NameFull: Wang, Zilan – PersonEntity: Name: NameFull: Teng, Haiying – PersonEntity: Name: NameFull: Chen, Zhouqing – PersonEntity: Name: NameFull: Kong, Yan – PersonEntity: Name: NameFull: Wang, Zhong IsPartOfRelationships: – BibEntity: Dates: – D: 01 M: 02 Text: Feb2024 Type: published Y: 2024 Identifiers: – Type: issn-print Value: 15901874 Numbering: – Type: volume Value: 45 – Type: issue Value: 2 Titles: – TitleFull: Neurological Sciences Type: main |
| ResultId | 1 |
