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학술연구/단체지원/교육 등 연구자 활동을 지속하도록 DBpia가 지원하고 있어요.
커뮤니티
연구자들이 자신의 연구와 전문성을 널리 알리고, 새로운 협력의 기회를 만들 수 있는 네트워킹 공간이에요.
논문 기본 정보
- 자료유형
- 학술저널
- 저자정보
- 발행연도
- 2018.1
- 수록면
- 407 - 412 (6page)
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초록· 키워드
오류제보하기
Background and Purpose Mechanical thrombectomy with or without intravenous thrombolysis is indicated in the acute treatment of ischemic strokes caused by an emergent largevessel occlusion (ELVO) within 6 hours from symptom onset. However, a significant proportion of patients are referred to comprehensive stroke centers beyond this therapeutic time window. This study performed a pooled analysis of data from trials in which mechanical thrombectomy was performed beyond 6 hours from symptom onset. Methods We searched for randomized controlled trials that compared mechanical thrombectomy with the best medical treatment beyond 6 hours for ischemic strokes due to ELVO and reported on between 1990 and April 2018. The intervention group comprised patients treated with mechanical thrombectomy. Statistical analysis was conducted while pooling data and analyzing fixed- or random-effects models as appropriate. Results Four trials involving 518 stroke patients met the eligibility criteria. There were 267 strokes treated with mechanical thrombectomy, with a median time of 10.8 hours between when the patient was last known to be well to randomization. We observed a significant difference between groups concerning the rate of functional independence at 90 days from stroke, with an absolute difference of 27.5% (odds ratio=3.33, 95% CI=1.81–6.12, p<0.001) and good recanalization (odds ratio=13.17, 95% CI=4.17–41.60, p<0.001) favoring the intervention group. Conclusions This meta-analysis confirms the efficacy of mechanical thrombectomy in selected ischemic stroke patients beyond 6 hours from symptom onset. The selection is mainly based on the limited core infarct detected by emergent assessment using neuroimaging techniques.
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참고문헌 (19)
참고문헌 신청
Saver JL / 2016 / Time to treatment with endovascular thrombectomy and outcomes from ischemic stroke: a meta-analysis / JAMA 316:1279~1288
Smith EE / 2017 / Increase in endovascular therapy in Get With The Guidelines-Stroke after the publication of the pivotal trials / Circulation 136:2303~2310
Bang OY / 2015 / Collateral circulation in ischemic stroke: assessment tools and therapeutic strategies / Stroke 46:3302~3309
Albers GW / 2018 / Thrombectomy for stroke at 6 to 16 hours with selection by perfusion imaging / N Engl J Med 378:708~718
Nogueira RG / 2018 / Thrombectomy 6 to 24 hours after stroke with a mismatch between deficit and infarct / N Engl J Med 378:11~21
Smith EE / 2017 / Increase in endovascular therapy in Get With The Guidelines-Stroke after the publication of the pivotal trials / Circulation 136:2303~2310
Bang OY / 2015 / Collateral circulation in ischemic stroke: assessment tools and therapeutic strategies / Stroke 46:3302~3309
Albers GW / 2018 / Thrombectomy for stroke at 6 to 16 hours with selection by perfusion imaging / N Engl J Med 378:708~718
Nogueira RG / 2018 / Thrombectomy 6 to 24 hours after stroke with a mismatch between deficit and infarct / N Engl J Med 378:11~21
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