RT Journal Article
SR Electronic
T1 Acute carotid stenting in patients undergoing thrombectomy: a systematic review and meta-analysis
JF Journal of NeuroInterventional Surgery
JO J NeuroIntervent Surg
FD BMJ Publishing Group Ltd.
SP 141
OP 145
DO 10.1136/neurintsurg-2020-015817
VO 13
IS 2
A1 Gabrielle Dufort
A1 Bing Yu Chen
A1 Grégory Jacquin
A1 Mark Keezer
A1 Marilyn Labrie
A1 Bastien Rioux
A1 Christian Stapf
A1 Daniela Ziegler
A1 Alexandre Y Poppe
YR 2021
UL http://jnis.bmj.com/content/13/2/141.abstract
AB Background The benefit of acute carotid stenting compared with no acute stenting on clinical outcomes among patients with tandem lesions (TL) undergoing endovascular thrombectomy (EVT) remains unknown.Methods We conducted a a systematic review and meta-analysis of studies comparing acute carotid stenting versus no stenting among TL patients undergoing EVT with regards to 90 day modified Rankin Scale (mRS) score, symptomatic intracerebral hemorrhage (sICH), and mortality. Four reviewers screened citations for eligibility and two assessed retained studies for risk of bias and data extraction. A random effects model was used for the synthesis of aggregated data.Results 21 studies (n=1635 patients) were identified for the systematic review; 19 were cohort studies, 1 was a post-hoc analysis of an EVT trial, and 1 was a pilot randomized controlled trial. 16 studies were included in the meta-analysis. Acute stenting was associated with a favorable 90 day mRS score: OR 1.43 (95% CI 1.07, 1.91). No significant heterogeneity between studies was found for this outcome (I2=17.0%; χ2=18.07, p=0.26). There were no statistically significant differences for 3 month mortality (OR 0.80 (95% CI 0.50, 1.28)) or sICH (OR 1.41 (95% CI 0.91, 2.19)).Conclusions This meta-analysis suggests that among TL patients undergoing EVT, acute carotid stenting is associated with a greater likelihood of favorable outcome at 90 days compared with no stenting.