%0 Generic %A Manning, Nathan W. %A Warne, Charles D. %A Meyers, Philip M. %D 2018 %T data_sheet_2_Reperfusion and Clinical Outcomes in Acute Ischemic Stroke: Systematic Review and Meta-Analysis of the Stent-Retriever-Based, Early Window Endovascular Stroke Trials.DOC %U https://frontiersin.figshare.com/articles/dataset/data_sheet_2_Reperfusion_and_Clinical_Outcomes_in_Acute_Ischemic_Stroke_Systematic_Review_and_Meta-Analysis_of_the_Stent-Retriever-Based_Early_Window_Endovascular_Stroke_Trials_DOC/6264176 %R 10.3389/fneur.2018.00301.s002 %2 https://frontiersin.figshare.com/ndownloader/files/11447645 %K stent-retriever %K endovascular %K stroke %K thrombectomy %K reperfusion %K meta-analysis %X Objective

To explore the effects of reperfusion grade rates on clinical outcomes in the setting of stent-retriever-based reperfusion therapy for anterior circulation stroke in early time windows.

Methods

Systematic searching of Medline and Embase databases was performed to identify stroke trials of stent-retriever-based therapy versus standard care. Mixed effects meta-regression was used to analyze the trial-level association between reperfusion rates and clinical outcomes.

Results

A total of five trials met the inclusion criteria (n = 1,287). Rates of successful reperfusion [modified thrombolysis in cerebral ischemia grade 2b/3] demonstrated strong evidence for an association with good functional outcomes [modified Rankin scale score (mRS) 0–2] OR 1.59 (95% CI 1.16, 2.19) p = 0.019 and very strong evidence for an association with excellent functional outcomes (mRS 0–1) OR 2.10 (95% CI 1.46, 3.01) p = 0.007. In addition, there was weak evidence for an association with symptomatic intracranial hemorrhage OR 0.54 (95% CI 0.28, 1.04) p = 0.057 and mortality OR 0.69 (95% CI 0.69, 1.01) p = 0.053.

Conclusion

In early, stent-retriever-based acute ischemic stroke treatment, reperfusion appears to be a major predictor of outcomes. Every 10% increase in the rates of successful reperfusion is associated with an 11% increase in the probability of achieving good and 17% increase in the probability of achieving excellent outcomes. Symptomatic intracranial hemorrhage and mortality may be decreased as reperfusion rates are improved.

%I Frontiers