Functional outcomes and recanalization rates of stent retrievers in acute ischaemic stroke: A systematic review and meta-analysis

Grech, Reuben; Mizzi, Adrian; Pullicino, Richard; Thornton, John; Downer, Jonathan

doi:10.1177/1971400915576678

Cited by 32 publications

(26 citation statements)

References 30 publications

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“…We believe that the predictive value of NLR for safety outcomes is equally applicable in AIS patients after EVT. Compared with IVT only, EVT combined with IVT can achieve a higher recanalization rate [31]. In the setting of a high successful recanalization rate (1) the predictive power of NLR for sICH may be attenuated; (2) a considerable proportion of patients with high NLR survived, which could affect the prediction of NLR for mortality.…”

Section: Discussionmentioning

confidence: 99%

Neutrophil-Lymphocyte Ratio Predicts Functional and Safety Outcomes after Endovascular Treatment for Acute Ischemic Stroke

Duan

Wang

et al. 2018

Cerebrovasc Dis

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Background and Objective: Endovascular treatment (EVT) is proven to be safe and effective for treating acute large vessel occlusion stroke (LVOS). The neutrophil-lymphocyte ratio (NLR) reflects systemic inflammation, which plays an important role in the process of treating ischemic stroke. This study aims to explore the relationship between NLR and the clinical outcomes of LVOS patients undergoing EVT. Methods: Patients were selected from the EVT for acUte Anterior circuLation (ACTUAL) ischemic stroke registry. The laboratory data (neutrophil count, lymphocyte count) before EVT were collected. Poor functional outcome was defined as modified Rankin Scale (mRS) of 3–6 at 3 months. Multivariable logistic regression analyses were performed to explore the relationship of NLR with functional outcome, symptomatic intracranial hemorrhage (sICH), and mortality. Results: We eventually included 616 patients (median of age, 66 years; 40.3% female). There were 350 (56.7%) patients achieving mRS of 3–6 at 3 months, 98 (15.9%) patients with sICH, and the mortality at 3 months was 24.8% (153/616). Baseline NLR was independently associated with poor functional outcome (OR 1.58; 95% CI 1.02–2.45; p = 0.039) and sICH (OR 1.84; 95% CI 1.09–3.11; p = 0.023) but showed a trend for predicting 3-month mortality (OR 1.57; 95% CI 0.94–2.65; p = 0.088). Conclusions: NLR independently predicts 3-month functional outcome and sICH but the existence of a trend association with mortality after EVT for acute anterior circulation LVOS patients.

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Section: Discussionmentioning

confidence: 99%

Neutrophil-Lymphocyte Ratio Predicts Functional and Safety Outcomes after Endovascular Treatment for Acute Ischemic Stroke

Duan

Wang

et al. 2018

Cerebrovasc Dis

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“…12 Stentrievers have greatly improved the endovascular results in MT for acute ischemic stroke, 8,32 and are partly responsible for the positive results of MT in the recent randomized trials. 3,5,11,15,26 In 2013, 3 randomized trials evaluating the effectiveness of endovascular treatment in acute ischemic stroke of the anterior circulation had proven inconclusive, 4,7,18 but only a minority of the patients included in these studies were treated with newgeneration devices such as stentrievers.…”

Section: Endovascular Procedures and Angiographic Resultsmentioning

confidence: 99%

“…12,31 We report the results of our single-center experience in endovascular mechanical treatment of ischemic stroke with BAO, focusing on the comparison between the most recent thrombectomy devices and the old ones, in terms of safety, recanalization rate, and clinical outcome.…”

mentioning

confidence: 99%

A leap forward in the endovascular management of acute basilar artery occlusion since the appearance of stent retrievers: a single-center comparative study

Fahed

Maria

Rosso

et al. 2017

Journal of Neurosurgery

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OBJECTIVE Contrary to acute ischemic stroke involving the anterior circulation, no randomized trial has yet demonstrated the safety and effectiveness of endovascular management in acute basilar artery occlusion (BAO). Recently developed thrombectomy devices, such as stentrievers and aspiration systems, have helped in improving the endovascular management of acute ischemic stroke. The authors sought to assess the impact of these devices in the endovascular treatment of acute BAO. METHODS A retrospective analysis of 34 consecutive patients treated in Pitié-Salpêtrière Hospital for acute BAO was carried out. All patients had undergone an endovascular procedure. In addition to the global results in terms of safety and effectiveness (recanalization rate and 3-month clinical outcome based on the modified Rankin Scale [mRS]), the authors aimed to determine if the patients treated with the most recently developed devices (i.e., the Solitaire stentriever or the ADAPT catheter) had better angiographic and clinical outcomes than those treated with older endovascular strategies. RESULTS The overall successful recanalization rate (thrombolysis in cerebral infarction score 2b-3) was 50% (17 of 34 patients). A good clinical outcome (mRS score 0-2 at 3-month follow-up) was achieved in 11 (32.3%) of 34 patients. The mortality rate at 3-month follow-up was 29.4% (10 of 34 patients). Patients treated with the Solitaire stentriever and the ADAPT catheter had a higher recanalization rate (12 [92.3%] of 13 patients vs 5 [23.8%] of 21 patients, p = 0.0002) and a shorter mean (± SD) procedure duration (88 ± 31 minutes vs 126 ± 58 minutes, p = 0.04) than patients treated with older devices. CONCLUSIONS The latest devices have improved the effectiveness of mechanical thrombectomy in acute BAO. Their use in further studies may help demonstrate a benefit in the endovascular management of acute BAO.

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“…The result of our pooled univariate -analysis (successfully reperfused patients have higher odds of getting favorable outcome than those who did not) added evidence to the importance of antegrade flow restore in acute BAO patients. It worth to be noted that successful reperfusion rate of BAO using SRT alone (73.2%) seemed lower than that reported in cases of proximal anterior circulation artery occlusion (84.5%) 28 , partly due to a higher rate of atherosclerosis in the vertebrobasilar artery than the internal carotid artery. communicating artery 7 12 29 .…”

Section: Accepted Manuscriptmentioning

confidence: 92%

Effect of Baseline Characteristics on the Outcome of Stent Retriever–Based Thrombectomy in Acute Basilar Artery Occlusions: A Single-Center Experience and Pooled Data Analysis

Wen

Zhang

et al. 2017

World Neurosurgery

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Functional outcomes and recanalization rates of stent retrievers in acute ischaemic stroke: A systematic review and meta-analysis

Cited by 32 publications

References 30 publications

Neutrophil-Lymphocyte Ratio Predicts Functional and Safety Outcomes after Endovascular Treatment for Acute Ischemic Stroke

Neutrophil-Lymphocyte Ratio Predicts Functional and Safety Outcomes after Endovascular Treatment for Acute Ischemic Stroke

A leap forward in the endovascular management of acute basilar artery occlusion since the appearance of stent retrievers: a single-center comparative study

Effect of Baseline Characteristics on the Outcome of Stent Retriever–Based Thrombectomy in Acute Basilar Artery Occlusions: A Single-Center Experience and Pooled Data Analysis

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