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Updated: Dec 13, 2025
Optimized Management of Endovascular Treatment for Acute Ischemic Stroke
Published on: January 18, 2018
Effectiveness of Endovascular Therapy for Patients with Acute Ischemic Stroke: A Meta-Analysis of Randomized
1Department of Neurology, The First Affiliated Hospital of Baotou Medical College, Inner Mongolia University of Science and Technology, Baotou, Inner Mongolia, China.
Objective:
This meta-analysis of published randomized controlled trials (RCTs) aimed to investigate the efficacy and safety of endovascular therapy (ET) for patients with acute ischemic stroke.
Methods:
The summary relative risks (RRs) with corresponding 95% confidence intervals were calculated to measure the effectiveness of ET using a random-effects model.
Results:
Thirteen RCTs including 3408 patients were identified among 2851 initial electronic citations. Overall, the summary RR indicated that ET significantly increased the incidence of a modified Rankin Scale score of 0-2 (RR, 1.50; P < 0.001), asymptomatic intracerebral hemorrhage (IH) (RR, 1.42; P = 0.001), subarachnoid hemorrhage (RR, 2.36; P = 0.001), and major complications due to non-intracerebral bleeding (RR, 1.47; P = 0.014). However, ET had no significant effects on the risk of 7-day death (P = 0.827); death after 30 days (P = 0.085); symptomatic IH (P = 0.288); type 1 (P = 0.413), type 2 (P = 0.300), and total parenchymal hematoma (P = 0.160); intraventricular hemorrhage (P = 0.244); early neurologic deterioration (P = 0.570); recurrent stroke (P = 0.830); and symptomatic edema (P = 0.485).
Conclusions:
The findings of this meta-analysis suggest the incidence of a modified Rankin Scale score of 0-2 in patients who received ET was significantly increased. Moreover, the harmful effects of ET might exist due to greater risk of asymptomatic IH, subarachnoid hemorrhage, and non-intracerebral bleeding, and these results should be verified by further large-scale long-term RCT.
