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Percutaneous vascular interventions versus intravenous thrombolytic treatment for acute ischaemic stroke.
CONCLUSIONS: The present review directly compared intravenous thrombolytic treatment with percutaneous vascular interventions for ischaemic stroke. We found no evidence from RCTs that percutaneous vascular interventions are superior to intravenous thrombolytic treatment with respect to functional outcome. Quality of evidence was low (outcome assessment was blinded, but not the treating physician or participants). New trials with adequate sample sizes are warranted because of the rapid development of new techniques and devices for such interventions. PMID: 30365156 [PubMed - as supplied by publisher]
Source: Cochrane Database of Systematic Reviews - October 26, 2018 Category: General Medicine Authors: Lindekleiv H, Berge E, Bruins Slot KM, Wardlaw JM Tags: Cochrane Database Syst Rev Source Type: research

Antiplatelet and anticoagulant agents for secondary prevention of stroke and other thromboembolic events in people with antiphospholipid syndrome.
CONCLUSIONS: The evidence identified indicates that NOACs compared with standard-dose VKAs may increase the risk of stroke and do not appear to alter the risk of other outcomes (moderate-certainty evidence). Using high-dose VKA versus standard-dose VKA did not alter the risk of any thromboembolic event or major bleeding but may increase the risk of any form of bleeding (low-certainty evidence). Standard-dose VKA combined with an AP agent compared with standard-dose VKA alone may increase the risk of any thromboembolic event and does not appear to alter the risk of major bleeding or other outcomes (low-certainty evidence). ...
Source: Cochrane Database of Systematic Reviews - October 12, 2020 Category: General Medicine Authors: Bala MM, Celinska-Lowenhoff M, Szot W, Padjas A, Kaczmarczyk M, Swierz MJ, Undas A Tags: Cochrane Database Syst Rev Source Type: research

Endovascular thrombectomy and intra-arterial interventions for acute ischaemic stroke
CONCLUSIONS: In individuals with acute ischaemic stroke due to large artery occlusion in the anterior circulation, endovascular thrombectomy can increase the chance of survival with a good functional outcome without increasing the risk of intracerebral haemorrhage or death.PMID:34125952 | DOI:10.1002/14651858.CD007574.pub3
Source: Cochrane Database of Systematic Reviews - June 14, 2021 Category: General Medicine Authors: Melinda B Roaldsen Mirza Jusufovic Eivind Berge Haakon Lindekleiv Source Type: research

Antithrombotic treatment after stroke due to intracerebral haemorrhage.
CONCLUSIONS: There is insufficient evidence from RCTs to support or discourage the use of antithrombotic treatment after ICH. RCTs comparing starting versus avoiding antiplatelet or anticoagulant drugs after ICH appear justified and are needed in clinical practice. PMID: 28540976 [PubMed - as supplied by publisher]
Source: Cochrane Database of Systematic Reviews - May 25, 2017 Category: General Medicine Authors: Perry LA, Berge E, Bowditch J, Forfang E, Rønning OM, Hankey GJ, Villanueva E, Al-Shahi Salman R Tags: Cochrane Database Syst Rev Source Type: research

Antithrombotic treatment after stroke due to intracerebral haemorrhage
CONCLUSIONS: We did not identify beneficial or hazardous effects of short-term prophylactic dose parenteral anticoagulation and long-term oral antiplatelet therapy after ICH on important outcomes. Although there was a significant reduction in MACE and all major occlusive vascular events after long-term treatment with therapeutic dose oral anticoagulation for atrial fibrillation after ICH, the pooled estimates were imprecise, the certainty of evidence was only moderate, and effects on other important outcomes were uncertain. Large RCTs with a low risk of bias are required to resolve the ongoing dilemmas about antithrombotic...
Source: Cochrane Database of Systematic Reviews - January 26, 2023 Category: General Medicine Authors: Alexia Cochrane Chen Chen Jacqueline Stephen Ole Morten R ønning Craig S Anderson Graeme J Hankey Rustam Al-Shahi Salman Source Type: research

Different types of percutaneous endovascular interventions for acute ischemic stroke
CONCLUSIONS: This review did not establish any difference in safety and effectiveness between the thrombo-aspiration approach and stent-retrieval thrombectomy for treating people with AIS. Furthermore, the combined group did not show any obvious advantage over either intervention applied alone.PMID:37249304 | DOI:10.1002/14651858.CD014676.pub2
Source: Cochrane Database of Systematic Reviews - May 30, 2023 Category: General Medicine Authors: Xuesong Bai Xiao Zhang Haozhi Gong Tao Wang Xue Wang Wenjiao Wang Kun Yang Wuyang Yang Yao Feng Yan Ma Bin Yang Antonio Lopez-Rueda Alejandro Tomasello Vikram Jadhav Liqun Jiao Source Type: research

Cell salvage for minimising perioperative allogeneic blood transfusion in adults undergoing elective surgery
CONCLUSIONS: In some types of elective surgery, cell salvage may reduce the need for and volume of allogeneic transfusion, alongside evidence of no difference in adverse events, when compared to no cell salvage. Further research is required to establish why other surgeries show no benefit from CS, through further analysis of the current evidence. More large RCTs in under-reported specialities are needed to expand the evidence base for exploring the impact of CS.PMID:37681564 | DOI:10.1002/14651858.CD001888.pub5
Source: Cochrane Database of Systematic Reviews - September 8, 2023 Category: General Medicine Authors: Thomas D Lloyd Louise J Geneen Keeley Bernhardt William McClune Scott J Fernquest Tamara Brown Carolyn Dor ée Susan J Brunskill Michael F Murphy Antony Jr Palmer Source Type: research

Hormone therapy for preventing cardiovascular disease in post-menopausal women.
CONCLUSIONS: Our review findings provide strong evidence that treatment with hormone therapy in post-menopausal women overall, for either primary or secondary prevention of cardiovascular disease events has little if any benefit and causes an increase in the risk of stroke and venous thromboembolic events. PMID: 25754617 [PubMed - as supplied by publisher]
Source: Cochrane Database of Systematic Reviews - March 10, 2015 Category: Journals (General) Authors: Boardman HM, Hartley L, Eisinga A, Main C, Roqué I Figuls M, Bonfill Cosp X, Gabriel Sanchez R, Knight B Tags: Cochrane Database Syst Rev Source Type: research

WITHDRAWN: Antiplatelet agents versus control or anticoagulation for heart failure in sinus rhythm.
CONCLUSIONS: At present there is little evidence from long term RCTs to recommend the use of antiplatelet therapy to prevent thromboembolism in patients with heart failure in sinus rhythm. A possible interaction with ACE inhibitors may reduce the efficacy of aspirin, although this evidence is mainly from retrospective analyses of trial cohorts and two RCTs. There is also no current evidence to support the use of oral anticoagulation (when compared to aspirin/clopidogrel) in patients with heart failure in sinus rhythm. Anticoagulation/antiplatelet therapy should be reserved for heart failure patients with other comorbiditie...
Source: Cochrane Database of Systematic Reviews - May 2, 2016 Category: Journals (General) Authors: Lip GY, Wrigley BJ, Pisters R Tags: Cochrane Database Syst Rev Source Type: research

Immediate versus delayed treatment for recently symptomatic carotid artery stenosis.
CONCLUSIONS: There is currently no high-quality evidence available to support either very early or delayed cerebral revascularization after a recent ischemic stroke. Hence, further randomized trials to identify which patients should undergo very urgent revascularization are needed. Future studies should stratify participants by age group, sex, grade of ischemia, and degree of stenosis. Currently, there is one ongoing RCT that is examining the timing of cerebral revascularization. PMID: 27611108 [PubMed - as supplied by publisher]
Source: Cochrane Database of Systematic Reviews - September 8, 2016 Category: Journals (General) Authors: Vasconcelos V, Cassola N, da Silva EM, Baptista-Silva JC Tags: Cochrane Database Syst Rev Source Type: research

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