Endovascular therapy for posterior cerebral artery occlusion: systematic review with meta-analysis

AbstractEndovascular therapy (EVT) is a highly effective stroke treatment, but trials validating this intervention did not include patients with posterior cerebral artery (PCA) occlusion. The aim of this systematic review with meta-analysis was to assess the efficacy and safety of EVT for acute PCA occlusion. PubMed, Scopus, ISI, and CENTRAL were searched for studies assessing EVT in adult patients with PCA occlusion. Outcomes of interest were recanalization, symptomatic intracerebral haemorrhage (sICH), mortality, functional independence, and excellent functional outcome at 90  days. Frequencies and odds ratios (ORs) were pooled using random effect models and heterogeneity was measured using theI2 statistic and explored by means of meta-regression. Fifteen studies were included, all observational. Recanalization rates were high [81%, 95% CI (73 –88%)] and sICH rates low [2%, 95% CI (1–4%)]. Heterogeneity was high for recanalization (I2 = 80%) but not for sICH, and not accounted for by any of the moderators tested. Compared to best medical treatment, EVT was associated with higher chances of sICH [OR = 2.04, 95% CI (1.12–3.71)] and no effect in functional independence [OR = 0.98, 95% CI (0.63–1.54)], with a tendenc y to higher chances of excellent functional outcome [OR = 1.29, 95% CI (0.90–1.86)] and mortality [OR = 1.56, 95% CI (0.84–2.90)]. EVT for acute PCA occlusion is technically feasible but associated with higher chance of sICH. There ...
Source: Internal and Emergency Medicine - Category: Emergency Medicine Source Type: research