Setting benchmark for ischemic stroke treated endovascularly: A systematic review and meta-analysis

Area of Science:

• Neurology
• Interventional Cardiology
• Medical Technology Evaluation

Background:

• Endovascular treatment for ischemic stroke requires standardized evaluation metrics.
• Current methods lack consistent benchmarks for efficacy and safety assessment.
• New devices and techniques necessitate comparison against established standards.

Purpose of the Study:

• To establish standardized benchmarks for endovascular stroke treatment evaluation.
• To analyze treatment efficacy and safety using meta-analysis.
• To facilitate comparison of novel interventions against quality control standards.

Main Methods:

• Systematic review and meta-analysis of randomized controlled trials (2015-2025).
• Inclusion of 35 studies from 1949 initial searches across MEDLINE, OVID, and Cochrane databases.
• Selected benchmarks: modified treatment in cerebral infarction (mTICI) ≥2b, modified Rankin Scale (mRS) ≤2, symptomatic hemorrhagic transformation rate, and death rate.

Main Results:

• Pooled mTICI ≥2b rate: 75.5% (95% CI: 75.7-81.5).
• Pooled mRS ≤2 rate: 43.5% (95% CI: 40.0-47.2).
• Symptomatic hemorrhagic transformation rate: 5.4% (95% CI: 4.5-6.4); Death rate: 18.4% (95% CI: 16.2-20.8) at 3 months.

Conclusions:

• Developed benchmarks provide reference standards for endovascular stroke treatments.
• Methodology improves evidence quality and aids clinical decision-making.
• Facilitates advancements in endovascular treatment technologies and quality control.