Is it dangerous to treat acute ischemic stroke by thrombolytic therapy in patients with comorbid intracranial aneurysms?

The American Journal of Emergency Medicine
Jiayue DingYue Jiang

Abstract

The safety of cerebral ischemic stroke patients with comorbid intracranial aneurysms treated by thrombolysis is still an unsolved mystery. We aimed to perform a secondary analysis and review to provide evidence on whether stroke patients with intracranial aneurysms have worse outcomes after thrombolysis. We searched almost all the relevant English articles published before June 21, 2015, using databases such as Medline, Embase, and Cochrane and tracked the acquired references to include the available articles. Data were processed using RevMan5.0 software provided by Cochrane collaboration, and relevant clinical guidelines, theory, retrospective studies, and case reports were summarized. We included 5 retrospective studies totaling 767 patients who met the inclusion and analytical criteria, which included 78 people with intracranial aneurysms. The total relative risk for patients with unruptured intracranial aneurysms developing intracranial hemorrhage after thrombolysis was 0.98 (95% confidence interval [CI], 0.60-1.58; P=.92; I(2)=22%). The total relative risk for symptomatic intracranial hemorrhage was 0.97 (95% CI, 0.37-2.57; P=.95; I(2)=40%). The total relative risk for mortality during hospitalization was 1.09 (95% CI, 0.3...Continue Reading

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Citations

Mar 16, 2018·International Journal of Stroke : Official Journal of the International Stroke Society·Yuji ShonoTakanari Kitazono
Sep 20, 2019·The Neurohospitalist·Rongzhi Ronda LunMichel Shamy

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