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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 | PMC:PMC10228464 | 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

Trunk training following stroke
CONCLUSIONS: There is evidence to suggest that trunk training as part of rehabilitation improves ADL, trunk function, standing balance, walking ability, upper and lower limb function, and quality of life in people after stroke. Core-stability, selective-, and unstable-trunk training were the trunk training approaches mostly applied in the included trials. When considering only trials with a low risk of bias, results were mostly confirmed, with very low to moderate certainty, depending on the outcome.PMID:36864008 | DOI:10.1002/14651858.CD013712.pub2
Source: Cochrane Database of Systematic Reviews - March 2, 2023 Category: General Medicine Authors: Liselot Thijs Eline Voets Stijn Denissen Jan Mehrholz Bernhard Elsner Robin Lemmens Geert Saf Verheyden Source Type: research

Endovascular therapy versus medical treatment for symptomatic intracranial artery stenosis
CONCLUSIONS: This review provides moderate-certainty evidence that ET plus CMT compared with CMT alone increases the risk of short-term stroke and death in people with recent symptomatic severe ICAS. This effect was still apparent at long-term follow-up but appeared to be due to the early risks of ET; therefore, there may be no clear difference between the interventions in terms of their effects on long-term stroke and death. The impact of delayed ET intervention (more than three weeks after a qualifying event) warrants further study.PMID:36738471 | PMC:PMC9897029 | DOI:10.1002/14651858.CD013267.pub3
Source: Cochrane Database of Systematic Reviews - February 4, 2023 Category: General Medicine Authors: Jichang Luo Tao Wang Kun Yang Xue Wang Ran Xu Haozhi Gong Xiao Zhang Jie Wang Renjie Yang Peng Gao Yan Ma Liqun Jiao 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

High versus low blood pressure targets for cardiac surgery while on cardiopulmonary bypass
CONCLUSIONS: A high blood pressure target may result in little to no difference in patient outcomes including acute kidney injury and mortality. Given the wide CIs, further studies are needed to confirm the efficacy of a higher blood pressure target among those who undergo cardiac surgery with CPB.PMID:36448514 | DOI:10.1002/14651858.CD013494.pub2
Source: Cochrane Database of Systematic Reviews - November 30, 2022 Category: General Medicine Authors: Yuki Kotani Yuki Kataoka Junichi Izawa Shoko Fujioka Takuo Yoshida Junji Kumasawa Joey Sw Kwong Source Type: research

Antifibrinolytic therapy for aneurysmal subarachnoid haemorrhage
CONCLUSIONS: The current evidence does not support the routine use of antifibrinolytic drugs in the treatment of people with aneurysmal subarachnoid haemorrhage. More specifically, early administration with concomitant treatment strategies to prevent delayed cerebral ischaemia does not improve clinical outcome. There is sufficient evidence from multiple randomised controlled trials to incorporate this conclusion in treatment guidelines.PMID:36350005 | DOI:10.1002/14651858.CD001245.pub3
Source: Cochrane Database of Systematic Reviews - November 9, 2022 Category: General Medicine Authors: Menno R Germans Wouter J Dronkers Merih I Baharoglu Ren é Post Dagmar Verbaan Gabriel Je Rinkel Yvo Bwem Roos Source Type: research

Patch angioplasty versus primary closure for carotid endarterectomy
CONCLUSIONS: Compared with primary closure, carotid patch angioplasty may reduce the risk of perioperative arterial occlusion and long-term restenosis of the operated artery. It would appear to reduce the risk of ipsilateral stroke during the perioperative and long-term period and reduce the risk of any stroke in the long-term when compared with primary closure. However, the evidence is uncertain due to the limited quality of included trials.PMID:35920689 | PMC:PMC9347312 | DOI:10.1002/14651858.CD000160.pub4
Source: Cochrane Database of Systematic Reviews - August 3, 2022 Category: General Medicine Authors: Saritphat Orrapin Thoetphum Benyakorn Boonying Siribumrungwong Kittipan Rerkasem Source Type: research

Antiplatelet agents and anticoagulants for hypertension
CONCLUSIONS: There is no evidence that antiplatelet therapy modifies mortality in patients with elevated BP for primary prevention. ASA reduced the risk of cardiovascular events and increased the risk of major bleeding events. Antiplatelet therapy with ASA probably reduces the risk of non-fatal and all cardiovascular events when compared to clopidogrel. Clopidogrel increases the risk of major bleeding events compared to ASA in patients with elevated BP for secondary prevention. There is no evidence that warfarin modifies mortality in patients with elevated BP for secondary prevention. The benefits and harms of the newer dr...
Source: Cochrane Database of Systematic Reviews - July 28, 2022 Category: General Medicine Authors: Eduard Shantsila Monika Kozie ł-Siołkowska Gregory Yh Lip Source Type: research

Type of anaesthesia for acute ischaemic stroke endovascular treatment
CONCLUSIONS: In early outcomes, general anaesthesia improves target artery revascularisation compared to non-general anaesthesia with moderate-certainty evidence. General anaesthesia may improve adverse events (haemodynamic instability) compared to non-general anaesthesia with low-certainty evidence. We found no evidence of a difference in neurological impairment, stroke-related mortality, all intracranial haemorrhage and haemodynamic instability adverse events between groups with low-certainty evidence. We are uncertain whether general anaesthesia improves functional outcomes and time to revascularisation because the cert...
Source: Cochrane Database of Systematic Reviews - July 20, 2022 Category: General Medicine Authors: Renato Tosello Rachel Riera Giuliano Tosello Caroline Nb Clezar Jorge E Amorim Vladimir Vasconcelos Benedito B Joao Ronald Lg Flumignan Source Type: research

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