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논문 기본 정보

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학술저널
저자정보
Mohamad Abdalkader (Departments of Radiology and Neurology Boston Medical Center Boston University Chobanian & Avedisian School of Medicine Boston MA USA) Stephanos Finitsis (Department of Radiology Aristotle University of Thessaloniki Thessaloniki Greece) Chuanhui Lic Wei Hu (dDepartment of Neurology and Stroke Center The First Affiliated Hospital of USTC Division of Life Sciences and Medicine University of Science and Technology of China Hefei China) Xinfeng Liu (Department of Neurology and Stroke Center The First Affiliated Hospital of USTC Division of Life Sciences and Medicine University of Science and Technology of China Hefei China) Xunming Ji (Department of Neurosurgery Xuanwu Hospital of Capital Medical University Beijing China) Xiaochuan Huo (Interventional Neuroradiology Beijing Tiantan Hospital Beijing China) Fana Alemseged (Medicine and Neurology Melbourne Brain Centre at the Royal Melbourne Hospital University of Melbourne Parkville VC Australia) Zhongming Qiu (Department of Neurology The 903rd Hospital of The Chinese People’s Liberation Army Hangzhou China) Daniel Strbian (Neurology Helsinki University Hospital University of Helsinki Helsinki Finland) Volker Puetz (Neurology University Hospital Carl Gustav Carus Technische Universität Dresden Dresden Germ) James E. Siegler (Cooper Neurological Institute Cooper University Hospital Camden NJ USA) Shadi Yaghi (Department of Neurology Brown University Providence RI USA) Kaiz Asif (Amita Health and University of Illinois-Chicago Chicago IL USA) Piers Klein (Departments of Radiology and Neurology Boston Medical Center Boston University Chobanian & Avedisian School of Medicine Boston MA USA) Yuyou Zhu (Department of Neurology and Stroke Center The First Affiliated Hospital of USTC Division of Life Sciences and Medicine University of Science and Technology of China Hefei China) Bruce C.V. Campbell (Medicine and Neurology Melbourne Brain Centre at the Royal Melbourne Hospital University of Melbourne Parkville VC Australia) Hui-Sheng Chen (Department of Neurology General Hospital of Northern Theatre Command Shenyang China) Simon Nagel (Neurology Heidelberg University Hospital Heidelberg Germany) Georgios Tsivgoulis (Attikon University Hospital National and Kapodistrian University of Athens Athens Greece) Zhongrong Miao (Interventional Neuroradiology Beijing Tiantan Hospital Beijing China) Raul G. Nogueira (Department of Neurology Neurosurgery University of Pittsburgh Medical Center Pittsburgh PA USA) Tudor G. Jovin (Cooper Neurological Institute Cooper University Hospital Camden NJ USA) Wouter J. Schonewille (Department of Neurology St. Antonius Hospital Nieuwegein the Netherlands) Thanh N. Nguyen (Boston Medical Center Boston University School of Medicine Boston MA USA)
저널정보
대한뇌졸중학회 대한뇌졸중학회지 대한뇌졸중영문학회지 제25권 제1호
발행연도
2023.1
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81 - 91 (11page)

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Background and Purpose The optimal management of patients with acute basilar artery occlusion (BAO) is uncertain. We aimed to evaluate the safety and efficacy of endovascular thrombectomy (EVT) compared to medical management (MM) for acute BAO through a meta-analysis of randomized controlled trials (RCTs). Methods We performed a systematic review and meta-analysis of RCTs of patients with acute BAO. We analyzed the pooled effect of EVT compared to MM on the primary outcome (modified Rankin Scale [mRS] of 0–3 at 3 months), secondary outcome (mRS 0–2 at 3 months), symptomatic intracranial hemorrhage (sICH), and 3-month mortality rates. For each study, effect sizes were computed as odds ratios (ORs) with random effects and Mantel-Haenszel weighting. Results Four RCTs met inclusion criteria including 988 patients. There were higher odds of mRS of 0-3 at 90 days in the EVT versus MM group (45.1% vs. 29.1%, OR 1.99, 95% confidence interval [CI] 1.04–3.80; P=0.04). Patients receiving EVT had a higher sICH compared to MM (5.4% vs. 0.8%, OR 7.89, 95% CI 4.10–15.19; P<0.01). Mortality was lower in the EVT group (35.5% vs. 45.1%, OR 0.64, 95% CI 0.42–0.99; P=0.05). In an analysis of two trials with BAO patients and National Institutes of Health Stroke Scale (NIHSS) <10, there was no difference in 90-day outcomes between EVT versus MM. Conclusion In this systematic review and meta-analysis, EVT was associated with favorable outcome and decreased mortality in patients with BAO up to 24 hours from stroke symptoms compared to MM. The treatment effect in BAO patients with NIHSS <10 was less certain. Further studies are of interest to evaluate the efficacy of EVT in basilar occlusion patients with milder symptoms.
#Acute stroke #Acute basilar artery occlusion #Posterior circulation #Meta-analysis

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