Bad research, not measuring 100% recovery.
Outcomes after Thrombectomy for Minor Stroke: A Meta-Analysis
Abstract
Purpose
The purpose of this study was to determine the outcomes after mechanical thrombectomy (MT) versus medical management in patients with minor stroke symptomatology.
Methods
A meta-analysis was performed for studies reporting outcomes after mechanical thrombectomy, either as stand-alone therapy or with intravenous thrombolysis (IVT) in patients with minor stroke with LVO.
Results
Fourteen studies with 2,134 patients met the selection criteria and were included. Two studies compared immediate thrombectomy (IMT) versus best medical management (with rescue thrombectomy) and the ORs of excellent outcomes, good outcomes, mortality and incidence of sICH after IMT vs BMM were 1.07 (95% CI: 0.93 – 1.22%),1.15 (95% CI 1.05 – 1.25), 0.65 (95% CI 0.30 – 1.38), and 2.89 (95% CI: 0.82 – 10.13) respectively. Among the 8 studies that compared mechanical thrombectomy (MT) outcomes versus medical management (without thrombectomy), ORs of excellent outcomes, good outcomes, mortality and incidence of sICH after MT vs MM were 0.98 (95% CI: 0.89 – 1.07), 0.94 (95% CI: 0.89 – 1.00), 1.61 (95% CI: 1.08 – 2.41), and 2.59 (95% CI: 1.35 – 4.96) respectively. Among all 14 studies, pooled proportions of excellent outcomes, good outcomes, mortality and sICH after thrombectomy were 58.7%, 76.2%, 6.82%, and 3.23% respectively.
Conclusion
Our study shows significant selection bias and heterogeneity in the literature with differences in baseline characteristics (age, stroke severity, pre-stroke mRS, side of infarct, vessel and site of occlusion, use of IVT, criteria for clinical deterioration and selection bias for rescue MT and rates of reperfusion), emphasizing the need for a randomized controlled trial.
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