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논문 기본 정보

자료유형
학술저널
저자정보
Rami Z. Morsi (Department of Neurology University of Chicago) Mohamed Elfil (Department of Neurological Sciences University of Nebraska Medical Center) Hazem S. Ghaith (Faculty of Medicine Al-Azhar University) Mohammad Aladawi (Department of Neurological Sciences University of Nebraska Medical Center) Ahmad Elmashad (Department of Neurology University of Connecticut) Sachin Kothari (Department of Neurology University of Chicago) Harsh Desai (Department of Neurology University of Chicago) Shyam Prabhakaran (Department of Neurology University of Chicago) Fawaz Al-Mufti (Department of Neurosurgery Westchester Medical Center) Tareq Kass-Hout (Department of Neurology University of Chicago)
저널정보
대한뇌졸중학회 대한뇌졸중학회지 대한뇌졸중영문학회지 제25권 제2호
발행연도
2023.5
수록면
214 - 222 (9page)
DOI
10.5853/jos.2023.00752

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Background and Purpose New studies have shown that endovascular thrombectomy (EVT) is safe and effective for acute ischemic stroke (AIS) patients with large ischemic areas. The aim of our study is to conduct a living systematic review and meta-analysis of randomized trials comparing EVT versus medical management only.Methods We searched MEDLINE, Embase, and the Cochrane Library to identify randomized controlled trials (RCTs) comparing EVT versus medical management alone in AIS patients with large ischemic regions. We conducted our meta-analysis using fixed-effect models to compare functional independence, mortality, and symptomatic intracranial hemorrhage (sICH) between EVT and standard medical management only. We assessed the risk of bias using the Cochrane risk-of-bias tool and the certainty of evidence for each outcome using the Grading of Recommendations, Assessment, Development, and Evaluations approach.Results Of 14,513 citations, we included 3 RCTs with a total of 1,010 participants. We found low-certainty evidence of possibly a large increase in the proportion of patients with functional independence (risk difference [RD] 30.3%, 95% CI 15.0% to 52.3%), low-certainty evidence of possibly a small non-significant decrease in mortality (RD -0.7%, 95% CI -3.8% to 3.5%), and low-certainty evidence of possibly a small non-significant increase in sICH (RD 3.1%, 95% CI -0.3% to 9.8%) for AIS patients with large infarcts who underwent EVT compared to medical management only.Conclusion Low-certainty evidence shows that there is possibly a large increase in functional independence, a small non-significant decrease in mortality, and a small non-significant increase in sICH amongst AIS patients with large infarcts undergoing EVT compared to medical management only.

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