Abstract Details

Title Long-term Efficacy and Safety of Endovascular Thrombectomy for Acute Ischemic Stroke with Large Vessel Occlusion: A Systematic Review and Meta-Analysis

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) P7 - Poster Session 7 (5:00 PM-6:00 PM)

Poster/Presentation
Number 13-008

Objective We conducted a systematic review and meta-analysis to evaluate the efficacy and safety of endovascular thrombectomy (EVT) beyond 90 days in patients of acute ischemic stroke (AIS) with large vessel occlusion (LVO).

Background EVT improves functional outcomes in patients of acute ischemic stroke at 90 days. However, its long-term efficacy and safety beyond 90 days remain uncertain.

Design/Methods PubMed, Embase, Scopus, and Cochrane Central databases were searched to identify randomized controlled trials (RCTs) comparing EVT plus medical therapy (MT) versus MT alone in AIS patients with LVO. Primary outcomes included functional independence (mRS ≤2), independent ambulation (mRS ≤3), death or dependency (mRS 4-6) and all-cause mortality beyond 90 days. We applied a random effects model and pooled risk ratios (RRs) along with 95% confidence interval (CI) using RevMan 5.4. Quality assessment was performed using the Rob2 tool.

Results Six RCTs with 1,856 patients (57% males) were included. The mean age of the patients was 68.9 years and mean follow up duration was 1.08 years. The results showed that EVT combined with MT improved functional independence (mRS ≤2) (RR 2.41, CI: 1.52-3.83; P = 0.0002), independent ambulation (mRS ≤3) (RR 1.76, CI: 1.31-2.37; P = 0.0002), and quality of life (SMD 0.43; CI: 0.26-0.59; P < 0.00001) beyond 90-days compared to MT alone. Moreover, the EVT plus MT group also had a significantly reduced death or dependency (mRS 4-6) (RR 0.77, CI: 0.71-0.83; P < 0.00001) and all-cause mortality (RR 0.86, CI: 0.77-0.96; P = 0.005) beyond 90-days than MT group. All RCTs were rated as low risk of bias.

Conclusions

EVT combined with medical treatment significantly improves long-term functional outcomes and quality of life as well as reduces mortality in AIS patients with LVO than medical treatment alone.

Authors/Disclosures
Megha Joshi, MBBS PRESENTER	Dr. Joshi has received personal compensation for serving as an employee of Essen Healthcare. Dr. Joshi has received personal compensation for serving as an employee of CityMD. Dr. Joshi has received personal compensation in the range of $100,000-$499,999 for serving as a Consultant for SGS Consulting.
Muhammad Osama, MBBS	Dr. Osama has nothing to disclose.
Sufyan Shahid, MBBS	Mr. Shahid has nothing to disclose.
Muhammad Abdullah Ali, MBBS	Dr. Ali has nothing to disclose.
Soban A. Qasim, MBBS	Dr. Qasim has nothing to disclose.
Muhammad Shaheer Bin Faheem, MBBS	Dr. Faheem has nothing to disclose.

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