Abstract:
Purpose: This study aims to analyse the efficacy of different treatment methods for acute basilar artery occlusion, with an emphasis placed on evaluating the latest treatment methods. Method: A systematic review and meta-analysis was performed to analyse the current data on the therapies available for treating acute basilar artery occlusion. Results: A total of 102 articles were included. The weighted pooled rate of mortality was 43.16% (95% CI 38.35-48.03%) in the intravenous thrombolysis group, 45.56% (95% CI 39.88-51.28) in the intra-arterial thrombolysis group, and 31.40% (95% CI 28.31-34.56%) for the endovascular thrombectomy group. The weighted pooled rate of Modified Ranking Score (mRS) 0-2 at 3 months was 31.40 (95% CI 28.31-34.56%) in the IVT group, 28.29% (95% CI 23.16-33.69%) in the IAT group, and 35.22% (95% CI 32.39-38.09%) for the EVT group. Meta-analyses were also done for the secondary outcomes of recanalization and symptomatic haemorrhage. There was no difference between stent retriever and thrombo-aspiration thrombectomy on subgroup analysis in both clinical outcome and safety profile. Limitations: The included studies were observational in nature. There was significant heterogeneity in some of the outcomes. Conclusions: Superior outcomes and better recanalization rates for acute basilar occlusion were seen with patients managed with endovascular thrombectomy when compared with either intravenous and/or intraarterial thrombolysis. No superiority of stent-retrievers over thrombo-aspiration thrombectomy was seen.
摘要:
目的:本研究旨在分析不同治疗方法对急性基底动脉闭塞的疗效,重点放在评估最新的治疗方法。方法:进行系统评价和荟萃分析,以分析可用于治疗急性基底动脉闭塞的治疗方法的当前数据。结果:共纳入102篇文献。静脉溶栓组的加权合并死亡率为43.16%(95%CI38.35-48.03%),动脉内溶栓组为45.56%(95%CI39.88-51.28),血管内血栓切除术组为31.40%(95%CI28.31-34.56%)。在IVT组中,3个月时修改排名评分(mRS)0-2的加权合并率为31.40(95%CI28.31-34.56%),IAT组28.29%(95%CI23.16-33.69%),EVT组为35.22%(95%CI32.39-38.09%)。还对再通和症状性出血的次要结局进行了荟萃分析。在临床结果和安全性方面,在亚组分析中,支架取出器和血栓抽吸术之间没有差异。局限性:纳入的研究本质上是观察性的。在一些结果中存在显著的异质性。结论:与静脉和/或动脉内溶栓相比,接受血管内血栓切除术的患者对急性基底动脉闭塞的预后和再通率更高。未发现支架取出器优于血栓抽吸术。