Stroke: meta-analysis finds better outcomes from endovascular treatment

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Takeaway

  • A meta-analysis suggests that endovascular treatment is associated with favorable or excellent outcomes compared with best medical treatment in patients with acute ischemic stroke.

Study design

  • 15 randomized trials, including 2980 patients, that compared endovascular treatment with best medical treatment were subjected to meta-analysis, with a primary endpoint of outcome by modified Rankin scale.

Key results

  • Patients who received endovascular treatment had significantly higher rates of favorable outcomes (OR=1.82 [95% CI, 1.38-2.40], P<.001) and excellent outcomes (OR=1.77 [95% CI, 1.29-2.43], P<.001).
  • Patients who received endovascular treatment and patients who received best medical treatment had similar risk of symptomatic intracranial hemorrhage (OR=1.19 [95% CI, 0.84-1.68], P=.34).

Why this matters

  • Randomized trials assessing the efficacy of endovascular treatment have shown conflicting results.