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Endovascular Therapy Versus No Endovascular Therapy in Patients Receiving Best Medical Management for Acute Isolated Occlusion of the Posterior Cerebral Artery: a Systematic Review and Meta-Analysis

2022-09Journal article Open access
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dc.contributor.authorBerberich, A
dc.contributor.authorFinitsis, S
dc.contributor.authorStrambo, D
dc.contributor.authorMichel, P
dc.contributor.authorHerweh, C
dc.contributor.authorMeyer, L
dc.contributor.authorHanning, U
dc.contributor.authorStrbian, D
dc.contributor.authorAbdalkader, M
dc.contributor.authorNogueira, R
dc.contributor.authorPuetz, V
dc.contributor.authorKaiser, D
dc.contributor.authorOlive-Gadea, M
dc.contributor.authorRibo, M
dc.contributor.authorFragata, I
dc.contributor.authorMarto, JP
dc.contributor.authorRomoli, M
dc.contributor.authorRingleb, P
dc.contributor.authorNguyen, T
dc.contributor.authorNagel, S
dc.date.accessioned2023-04-06T12:16:46Z
dc.date.available2023-04-06T12:16:46Z
dc.date.issued2022-09
dc.description.abstractBackground and purpose: Endovascular therapy (EVT) is increasingly reported for treatment of isolated posterior cerebral artery (PCA) occlusions although its clinical benefit remains uncertain. This study-level meta-analysis investigated the functional outcomes and safety of EVT and best medical management (BMM) compared to BMM alone for treatment of PCA occlusion stroke. Methods: We conducted a literature search in PubMed, Web of Science and Embase for studies in patients with isolated PCA occlusion stroke treated with EVT + BMM or BMM including intravenous thrombolysis. There were no randomized trials and all studies were retrospective. The primary outcome was modified Rankin Scale score of 0-2 at 3 months, while safety outcomes included mortality rate and incidence of symptomatic intracranial hemorrhage (sICH). Results: Twelve studies with a total of 679 patients were included in the meta-analysis: 338 patients with EVT + BMM and 341 patients receiving BMM alone. Good functional outcome at 3 months was achieved in 58.0% (95% confidence interval [CI] 43.83-70.95) of patients receiving EVT + BMM and 48.1% (95% CI 40.35-55.92) of patients who received BMM alone, with respective mortality rates of 12.6% (95% CI 7.30-20.93) and 12.3% (95% CI 8.64-17.33). sICH occurred in 4.2% (95% CI 2.47-7.03) of patients treated with EVT + BMM and 3.2% (95% CI 1.75-5.92) of patients treated with BMM alone. Comparative analyses were performed on studies that included both treatments and these demonstrated no significant differences. Conclusions: Our results demonstrate that EVT represents a safe treatment for patients with isolated PCA occlusion stroke. There were no differences in clinical or safety outcomes between treatments, supporting randomization of future patients into distal vessel occlusion trials.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationEur J Neurol . 2022;29(9):2664-2673.pt_PT
dc.identifier.doi10.1111/ene.15410.pt_PT
dc.identifier.urihttp://hdl.handle.net/10400.17/4475
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherWileypt_PT
dc.subjectHSJ NRADpt_PT
dc.subjectHumanspt_PT
dc.subjectEndovascular Procedures* / methodspt_PT
dc.subjectIntracranial Hemorrhages / etiologypt_PT
dc.subjectPosterior Cerebral Arterypt_PT
dc.subjectRetrospective Studiespt_PT
dc.subjectStroke* / etiologypt_PT
dc.subjectThrombectomy / methodspt_PT
dc.subjectThrombolytic Therapy / methodspt_PT
dc.subjectTreatment Outcomept_PT
dc.titleEndovascular Therapy Versus No Endovascular Therapy in Patients Receiving Best Medical Management for Acute Isolated Occlusion of the Posterior Cerebral Artery: a Systematic Review and Meta-Analysispt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.endPage2673pt_PT
oaire.citation.startPage2664pt_PT
oaire.citation.titleEuropean Journal of Neurologypt_PT
oaire.citation.volume29pt_PT
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT

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