Do Outcomes between Women and Men Differ after Endovascular Thrombectomy? A Meta-analysis

Area of Science:

• Neurology
• Interventional Cardiology
• Public Health

Background:

• Existing research on sex-based differences in endovascular thrombectomy outcomes for acute ischemic stroke presents conflicting findings.
• Understanding these differences is crucial for optimizing stroke treatment strategies.

Purpose of the Study:

• To systematically investigate whether sex influences patient outcomes following endovascular thrombectomy for large-vessel occlusion stroke.
• To provide a comprehensive analysis of sex-specific results in stroke intervention.

Main Methods:

• A systematic review and meta-analysis of 33 studies involving 7335 patients undergoing endovascular thrombectomy.
• Pooled analysis of outcomes including 90-day modified Rankin Scale score, mortality, symptomatic intracranial hemorrhage, and recanalization, stratified by sex.

Main Results:

• Men demonstrated significantly better 90-day functional outcomes (modified Rankin Scale score ≤ 2) compared to women (OR = 1.29; P < .001).
• No significant sex-based differences were observed in 90-day mortality, symptomatic intracranial hemorrhage, or recanalization rates.
• Moderate heterogeneity was noted, with most included studies being retrospective.

Conclusions:

• Women undergoing endovascular thrombectomy for large-vessel occlusion stroke experience poorer 90-day clinical outcomes.
• Further research, including sex-specific clinical trials and pathophysiological studies, is warranted to explore these disparities.