Acute carotid stenting in patients undergoing thrombectomy: a systematic review and meta-analysis.

Journal of Neurointerventional Surgery
Gabrielle DufortAlexandre Y Poppe

Abstract

The benefit of acute carotid stenting compared with no acute stenting on clinical outcomes among patients with tandem lesions (TL) undergoing endovascular thrombectomy (EVT) remains unknown. We conducted a a systematic review and meta-analysis of studies comparing acute carotid stenting versus no stenting among TL patients undergoing EVT with regards to 90 day modified Rankin Scale (mRS) score, symptomatic intracerebral hemorrhage (sICH), and mortality. Four reviewers screened citations for eligibility and two assessed retained studies for risk of bias and data extraction. A random effects model was used for the synthesis of aggregated data. 21 studies (n=1635 patients) were identified for the systematic review; 19 were cohort studies, 1 was a post-hoc analysis of an EVT trial, and 1 was a pilot randomized controlled trial. 16 studies were included in the meta-analysis. Acute stenting was associated with a favorable 90 day mRS score: OR 1.43 (95% CI 1.07, 1.91). No significant heterogeneity between studies was found for this outcome (I2=17.0%; χ2=18.07, p=0.26). There were no statistically significant differences for 3 month mortality (OR 0.80 (95% CI 0.50, 1.28)) or sICH (OR 1.41 (95% CI 0.91, 2.19)). This meta-analysis sugges...Continue Reading

References

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Dec 7, 2016·Systematic Reviews·Mourad OuzzaniAhmed Elmagarmid
Mar 5, 2017·Journal of Vascular and Interventional Radiology : JVIR·Fabrizio SallustioRoberto Gandini
Oct 13, 2017·Journal of Neurointerventional Surgery·Zarina AssisUNKNOWN ESCAPE Trialists
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Dec 26, 2018·Stroke; a Journal of Cerebral Circulation·François ZhuUNKNOWN TITAN (Thrombectomy in Tandem Lesions) Investigators
Mar 21, 2019·Stroke; a Journal of Cerebral Circulation·Gregory JacquinChristian Stapf
Sep 30, 2019·Journal of Neuroradiology. Journal De Neuroradiologie·Alexandre Y PoppeJean Raymond
Dec 24, 2019·Journal of Stroke and Cerebrovascular Diseases : the Official Journal of National Stroke Association·Francisco Hernández-FernándezTomás Segura

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Citations

Dec 17, 2020·Journal of Neurointerventional Surgery·Cynthia B ZevallosSantiago Ortega-Gutierrez
May 6, 2021·Journal of Neurointerventional Surgery·Martha MarkoUNKNOWN ESCAPE-NA1 investigators
Aug 11, 2021·Stroke; a Journal of Cerebral Circulation·Luciana CataneseAlexandre Y Poppe
Nov 26, 2021·Neuroradiology·Mohamed Nabil MahmoudMohamed A Abdalla
Jan 14, 2022·Journal of the American Heart Association·Cynthia B ZevallosSantiago Ortega-Gutierrez

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