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Ischemic stroke and infarct in a new territory following mechanical thrombectomy: a meta-analysis of clinical trials
  1. Melika Amoukhteh1,2,
  2. Amir Hassankhani1,2,
  3. Parya Valizadeh1,
  4. Payam Jannatdoust1,
  5. Sherief Ghozy1,
  6. David F Kallmes1
  1. 1 Department of Radiology, Mayo Clinic, Rochester, MN, USA
  2. 2 Department of Radiology, Keck School of Medicine, University of Southern California (USC), Los Angeles, CA, USA
  1. Correspondence to Dr Amir Hassankhani, Department of Radiology, Mayo Clinic, Rochester, Minnesota 55905, USA; ah_620{at}usc.edu

https://doi.org/10.1136/jnis-2023-020778

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    The occurrence of ischemic stroke in a new territory (ISNT) and infarct in a new territory (INT) is a significant concern when it comes to mechanical thrombectomy (MT) as a treatment for acute ischemic stroke resulting from large vessel occlusion. These complications arise when imaging confirms ischemia and infarction in a vascular territory that is different from the original site of occlusion prior to the MT procedure.1 2 It has been observed that these lesions are associated with poorer outcomes for patients.2 In order to gain a clearer understanding of the occurrence rates of ISNT and INT, we conducted a systematic review of clinical trials and performed a meta-analysis to pool the reported rates of these complications.

    In accordance with the PRISMA statement guidelines,3 we performed a comprehensive literature search on June 13, 2023 using the PubMed and Scopus databases. Our search strategy involved the use of specific terms customized for each database, focusing on “mechanical thrombectomy” and “clinical trial”. Additional information regarding the search methodology, inclusion and exclusion criteria, screening and selection of articles, data extraction, as well as the statistical analysis methods used is summarized in the online supplemental file.

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    Footnotes

    • MA and AH are joint first authors.

    • Contributors The project’s conception involved the contributions of DFK and SG. Throughout the revision process, important scientific insights were provided by DFK and SG. MA and AH played crucial roles in conducting database searches, data extraction, drafting, and critically revising the work to ensure the inclusion of essential intellectual content. PV and PJ significantly contributed to data analysis and interpretation. All authors diligently reviewed and approved the final manuscript.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests DFK holds equity in Nested Knowledge, Superior Medical Editors, Conway Medical, Marblehead Medical, and Piraeus Medical. He receives grant support from MicroVention, Medtronic, Balt, and Insera Therapeutics. Additionally, he has served on the Data Safety Monitoring Board for Vesalio and has received royalties from Medtronic.

    • Provenance and peer review Not commissioned; internally peer reviewed.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.