TY - JOUR T1 - Reocclusion after successful endovascular treatment in acute ischemic stroke: systematic review and meta-analysis JF - Journal of NeuroInterventional Surgery JO - J NeuroIntervent Surg DO - 10.1136/jnis-2022-019382 SP - jnis-2022-019382 AU - Renato Oliveira AU - Manuel A Correia AU - João Pedro Marto AU - Mariana Carvalho Dias AU - Ghada A Mohamed AU - Thanh N Nguyen AU - Raul G Nogueira AU - Hassan Aboul-Nour AU - Horia Marin AU - Alex Bou Chebl AU - Mahmoud H Mohammaden AU - Alhamza R Al-Bayati AU - Diogo C Haussen AU - Mohamad Abdalkader AU - Johanna T Fifi AU - Santiago Ortega-Gutierrez AU - Dileep R Yavagal AU - Stephan A. Mayer AU - Georgios Tsivgoulis AU - Lia Lucas Neto AU - Diana Aguiar de Sousa Y1 - 2022/11/03 UR - http://jnis.bmj.com/content/early/2022/11/03/jnis-2022-019382.abstract N2 - Background Endovascular treatment (EVT) is the standard of care for selected patients with acute ischemic stroke (AIS) due to large vessel occlusion (LVO).Objective To systematically review the available data on: (1) incidence, predictors, and outcomes of patients with reocclusion after successful EVT for AIS and, (2) the characteristics, complications, and outcomes of patients with reocclusion treated with repeated EVT (rEVT) within 30 days of the first procedure.Methods PubMed was searched (between January 2012 and April 2021) to identify studies reporting reocclusion following successful EVT (Thrombolysis in Cerebral Infarction ≥2b) in patients with AIS due to LVO. Pooled incidence of reocclusion per 100 patients with successful recanalization following EVT was calculated using a random-effects model with Freeman-Tukey double arcsine transformation. Extracted incidences of reocclusion according to etiology and use of intravenous thrombolysis were pooled using random-effects meta-analytic models.Results A total of 840 studies was identified and seven studies qualified for the quantitative analysis, which described 91 same-vessel reocclusions occurring within the first 7 days after treatment among 2067 patients (4.9%; 95% CI 3% to 7%, I2=70.2%). Large vessel atherosclerosis was associated with an increased risk of reocclusion (OR=3.44, 95% CI 1.12 to 10.61, I2=50%). We identified 90 patients treated with rEVT for recurrent LVO, described in five studies. The rates of procedural complications, mortality, and unfavorable functional outcome at 3 months were 18.0%, 18.9%, and 60.3%, respectively.Conclusion In cohorts of patients with AIS due to LVO, 5% of patients experienced reocclusion within 7 days after successful EVT. Repeated EVT can be a safe and effective treatment for selected patients with reocclusion.Data are available upon reasonable request. ER -