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Efficacy and safety of mechanical thrombectomy for cardioembolic stroke: A protocol for systematic review and
Ziqu Zhang1, Chenjin Wang1, Wengang Xia2
1Chengdu University of Traditional Chinese Medicine, Chengdu.
Insights
Mechanical thrombectomy is effective for acute ischemic stroke, including cardioembolic stroke. This systematic review evaluates its safety and efficacy in treating cardioembolic stroke patients.
Area of Science:
- Neurology
- Interventional Cardiology
- Vascular Surgery
Background:
- Mechanical thrombectomy is established for large vessel occlusion acute ischemic stroke.
- Cardioembolic stroke historically had poorer outcomes with thrombectomy due to older emboli.
- Emerging evidence suggests mechanical thrombectomy may be effective for cardioembolic stroke.
Purpose of the Study:
- To evaluate the efficacy and safety of mechanical thrombectomy for cardioembolic stroke.
- To synthesize current evidence on mechanical thrombectomy outcomes in cardioembolic stroke patients.
Main Methods:
- Systematic review of randomized controlled trials (RCTs) up to December 1, 2021.
- Inclusion of RCTs assessing mechanical thrombectomy for cardioembolic stroke.
- Data extraction and risk of bias assessment using Cochrane tools.
Main Results:
- This systematic review will assess the efficacy and safety of mechanical thrombectomy in cardioembolic stroke.
- Primary outcomes include vascular recanalization rates and clinical score scales.
Conclusions:
- Findings may inform clinical decision-making for cardioembolic stroke treatment.
- Mechanical thrombectomy shows promise as a treatment for cardioembolic stroke.
Background:
Several randomized clinical trials have demonstrated the safety and efficiency of mechanical thrombectomy in the management of acute ischaemic stroke caused by larger vessel occlusion. According to the trial of Org 10172 in Acute Stroke Treatment (TOAST) classification, acute ischaemic stroke can be divided into cardioembolic stroke and non-cardioembolic stroke. Previous studies have shown that mechanical thrombectomy in cardioembolic stroke with intracranial large artery occlusion has a poor prognosis. The reason may be that the old emboli are hard, making it difficult to remove. However, recent evidence shows that mechanical thrombectomy is also effective and safe in patients with cardioembolic stroke. Therefore, the aim of this study is to evaluate the efficacy and safety of mechanical thrombectomy for cardioembolic stroke.
Methods:
The electronic database, including PubMed, Cochrane Library, EMBASE, the China National Knowledge Infrastructure (CNKI), China Biology Medicine disc (CBM), VIP database, and Wan-fang database, were thoroughly retrieved from inception to December 1, 2021, without language restrictions. All randomized controlled trials that evaluated the efficacy and safety of mechanical thrombectomy in the treatment of cardioembolic stroke will be included. Primary outcomes will include vascular recanalization rate and score scale. Two authors will independently scan the articles searched, extract the data from articles included, and assess the risk of bias by Cochrane tool of risk of bias. Disagreements will be resolved by discussion among authors. All analysis will be performed based on the Cochrane Handbook for Systematic Reviews of Interventions. Dichotomous variables will be reported as risk ratio or odds ratio with 95% confidence intervals and continuous variables will be summarized as mean difference or standard mean difference with 95% confidence intervals.
Results:
This review will be to assess the efficacy and safety of mechanical thrombectomy for cardioembolic stroke.
Conclusions:
The results of our findings may be helpful for clinicians and health professionals to re-examine the clinical decision-making in the treatment of cardioembolic stroke, promising way for treatment of patients with cardioembolic stroke.
Systematic Review Registration Number:
INPLASY2020120035.
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