300.1 A Meta-Analysis of Endovascular Therapy for Patients With Large Core Ischemic Stroke

Document Type

Conference Proceeding

Publication Date

2-1-2024

Publication Title

JACC Cardiovasc Interv

Abstract

Introduction: Endovascular therapy (EVT) is a recommended treatment for stroke patients with large vessel occlusion and an Alberta Stroke Program Early Computed Tomography Score (ASPECTS) ≥6. However, the utility of EVT in patients with large core ischemic stroke has not been well established. Methods: This meta-analysis assesses the efficacy and safety of EVT compared to medical management (MM) in patients with stroke and large ischemic core. The primary endpoint was the mean modified Rankin scale score at 90 days follow-up. We used Mantel-Haenszel method with Paule-Mandel estimator of tau2 and Hartung-Knapp-Sidik-Jonkman adjustment (due to the small number of the included trials) to calculate the standardized mean difference (SMD) for continuous outcomes and the risk ratio (RR) for other outcomes. Results: Five RCTs with a total of 1,547 patients were included in our analysis. EVT as compared with MM was associated with lower mean modified Rankin scale score at 90 days (SMD -0.32; 95% CI -0.46 to -0.18) [Figure]. There was no statistically significant difference in the risk of symptomatic intracranial hemorrhage (RR: 1.73; 95%CI: 0.95 to 3.13] and 90-day mortality (RR: 0.92; 95%CI: 0.77 to 1.11) between the two groups. Conclusion: Our meta-analysis suggests that EVT compared to MM may lead to improved outcomes in stroke patients with large core ischemia. [Formula presented]

Volume

17

Issue

4

First Page

S35

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