Bridging techniques compared with direct endovascular therapy for stroke due to tandem occlusion: A systematic review and meta-analysis

Yihang Sui; Yu Shi; Yanmei Yang; Jin Xiao; Yanru Zhou; Siyuan Zhang; Yue Qiu; Yang Xie; Zhiyu Lv

Asian Journal of Surgery (Mar 2024)

Bridging techniques compared with direct endovascular therapy for stroke due to tandem occlusion: A systematic review and meta-analysis

Yihang Sui,
Yu Shi,
Yanmei Yang,
Jin Xiao,
Yanru Zhou,
Siyuan Zhang,
Yue Qiu,
Yang Xie,
Zhiyu Lv

Affiliations

Yihang Sui: Department of Neurology, The Affiliated Hospital of Southwest Medical University, No.25 of Taiping Street, Luzhou, 646000, Sichuan, China
Yu Shi: Department of Neurosurgery, The Affiliated Hospital of Southwest Medical University, No.25 of Taiping Street, Luzhou, 646000, Sichuan, China
Yanmei Yang: Department of Neurology, The Affiliated Hospital of Southwest Medical University, No.25 of Taiping Street, Luzhou, 646000, Sichuan, China
Jin Xiao: Department of Neurology, The Affiliated Hospital of Southwest Medical University, No.25 of Taiping Street, Luzhou, 646000, Sichuan, China
Yanru Zhou: Department of Neurology, The Affiliated Hospital of Southwest Medical University, No.25 of Taiping Street, Luzhou, 646000, Sichuan, China
Siyuan Zhang: Department of Neurology, The Affiliated Hospital of Southwest Medical University, No.25 of Taiping Street, Luzhou, 646000, Sichuan, China
Yue Qiu: Department of Neurology, The Affiliated Hospital of Southwest Medical University, No.25 of Taiping Street, Luzhou, 646000, Sichuan, China
Yang Xie: Department of Neurology, The Affiliated Hospital of Southwest Medical University, No.25 of Taiping Street, Luzhou, 646000, Sichuan, China
Zhiyu Lv: Department of Neurology, The Affiliated Hospital of Southwest Medical University, No.25 of Taiping Street, Luzhou, 646000, Sichuan, China; Laboratory of Neurological Diseases and Brain Function, Luzhou, Sichuan, 646000, China; Corresponding author. Department of Neurology, The Affiliated Hospital of Southwest Medical University, No.25 of Taiping Street, Luzhou, 646000, Sichuan, China.

Journal volume & issue: Vol. 47, no. 3
pp. 1339 – 1343

Abstract

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The superiority of the bridging strategy of intravenous thrombolysis (IVT) plus endovascular therapy (EVT) to EVT alone for the anterior circulation with tandem vascular occlusion (TO) has not been specifically addressed by a single randomized trial. Analysis of 15 studies (n = 1857 patients) revealed that 90 Day good functional outcomes (MRS≤2) were better for bridging therapy (IVT + EVT) than for dEVT (OR:1.39, 95%CI: 1.09–1.79, p = 0.008); 90-day mortality was lower for IVT + EVT than for dEVT (OR: 0.57; 95%CI: 0.40–0.81, p = 0.002) and rates of successful recanalization were higher for IVT + EVT than for dEVT (OR: 1.79, 95%CI: 1.36–2.36, p<0.0001). However, there was no significant difference in the incidence of symptomatic. intracranial hemorrhage (sICH) between groups (OR 0.91, 95%CI 0.64–1.31, p = 0.62).In conclusion, Patients receiving IVT + EVT have a better functional outcome, lower death rate and a higher rate of successful recanalization than those receiving dEVT but there was no difference in sICH risk between the two treatments.

Published in Asian Journal of Surgery

ISSN: 1015-9584 (Print)
Publisher: Elsevier
Country of publisher: Hong Kong
LCC subjects: Medicine: Surgery
Website: http://www.journals.elsevier.com/asian-journal-of-surgery/

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