Mechanical Thrombectomy Outcomes With and Without Intravenous Thrombolysis in Stroke Patients: A Meta-Analysis
@article{Mistry2017MechanicalTO, title={Mechanical Thrombectomy Outcomes With and Without Intravenous Thrombolysis in Stroke Patients: A Meta-Analysis}, author={Eva A. Mistry and Akshitkumar M. Mistry and Mohammad Obadah Nakawah and Rohan V. Chitale and Robert F. James and John Volpi and Matthew R. Fusco}, journal={Stroke}, year={2017}, volume={48}, pages={2450–2456} }
Background and Purpose— Whether prior intravenous thrombolysis provides any additional benefits to the patients undergoing mechanical thrombectomy for large vessel, acute ischemic stroke remains unclear. Methods— We conducted a meta-analysis of 13 studies obtained through PubMed and EMBASE database searches to determine whether functional outcome (modified Rankin Scale) at 90 days, successful recanalization rate, and symptomatic intracerebral hemorrhage rate differed between patients who…
179 Citations
Mechanical Thrombectomy with or without Intravenous Thrombolysis in Acute Ischemic Stroke: A Meta-Analysis for Randomized Controlled Trials
- Medicine, BiologyEuropean Neurology
- 2021
Findings support the adoption of dMT in acute ischemic stroke treatments and have higher cost-effectiveness in global applications.
Outcomes of mechanical thrombectomy with pre-intravenous thrombolysis: a systematic review and meta-analysis
- Medicine, BiologyJournal of Neurology
- 2020
Pre-IVT provides extra benefits to MT on clinical and imaging outcomes without increasing symptomatic intracerebral hemorrhage in acute ischemic stroke of large vessel occlusion.
Direct mechanical thrombectomy in tPA-ineligible and -eligible patients versus the bridging approach: a meta-analysis
- MedicineJournal of NeuroInterventional Surgery
- 2018
The data suggest that dMTE may offer comparable safety and efficacy as compared with IVT+MTE when considering studies with lower selection bias, and the conduct of randomized-controlled clinical trials seems justified.
Intravenous Thrombolysis Prior to Mechanical Thrombectomy in Acute Ischemic Stroke: Silver Bullet or Useless Bystander?
- MedicineJournal of stroke
- 2018
IVT prior to MT is associated with increased excellent outcome and successful reperfusion rates, which support the use of bridging therapy.
Mechanical Thrombectomy Outcomes With or Without Intravenous Thrombolysis: Insight From the ASTER Randomized Trial
- MedicineStroke
- 2018
It is demonstrated that IVT associated with MT might improve functional outcome and recanalization while reducing mortality rates in a selected population of patients without prestroke anticoagulation.
Primary Thrombectomy Versus Combined Mechanical Thrombectomy and Intravenous Thrombolysis in Large Vessel Occlusion Acute Ischemic Stroke.
- MedicineJournal of stroke and cerebrovascular diseases : the official journal of National Stroke Association
- 2019
Intravenous Thrombolysis Before Mechanical Thrombectomy for Acute Ischemic Stroke: A Meta‐Analysis
- Medicine, PsychologyJournal of the American Heart Association
- 2021
These findings support the use of dMT without intravenous thrombolysis bridging therapy, and find no significant differences in 90‐day functional outcome or mortality between dMT and BT, but a lower rate of symptomatic intracranial hemorrhage for dMT.
Effect of mechanical thrombectomy alone or in combination with intravenous thrombolysis for acute ischemic stroke
- MedicineJournal of Neurology
- 2018
It is suggested that mechanical thrombectomy alone is effective and safe in patients with contraindications to intravenous thrombolysis and preceding use of IVT in eligible patients was not associated with increased harm or benefit.
Direct mechanical thrombectomy without intravenous thrombolysis versus bridging therapy for acute ischemic stroke: A meta-analysis of randomized controlled trials
- MedicineInternational journal of stroke : official journal of the International Stroke Society
- 2021
The pooled analysis indicates noninferiority of direct mechanical thrombectomy with a 4% margin of confidence, but the application of these findings is limited to patients presenting directly to mechanical thROMbectomy-capable centers and real-world workflow times may differ against those achieved in a trial setting.
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