Recurrence of cervical artery dissection: A systematic review and meta-analysis.

IF 6.3 2区医学 Q1 CLINICAL NEUROLOGY

International Journal of Stroke Pub Date : 2024-04-01 Epub Date: 2023-09-21 DOI:10.1177/17474930231201434

Elizabeth Lounsbury, Naomi Niznick, Ranjeeta Mallick, Brian Dewar, Alexandra Davis, Dean A Fergusson, Dar Dowlatshahi, Michel Shamy

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引用次数: 0

Abstract

Background and purpose: Cervical artery dissection (CAD) involving the carotid or vertebral arteries is an important cause of stroke in younger patients. The purpose of this systematic review is to assess the risk of recurrent CAD.

Methods: A systematic review and meta-analysis was conducted on studies in which patients experienced radiographically confirmed dissections involving an extracranial segment of the carotid or vertebral artery and in whom CAD recurrence rates were reported.

Results: Data were extracted from 29 eligible studies (n = 5898 patients). Analysis of outcomes was performed by pooling incidence rates with random effects models weighting by inverse of variance. The incidence of recurrent CAD was 4% overall (95% confidence interval (CI) = 3-7%), 2% at 1 month (95% CI = 1-5%), and 7% at 1 year in studies with sufficient follow-up (95% CI = 4-13%). The incidence of recurrence associated with ischemic events was 2% (95% CI = 1-3%).

Conclusions: We found low rates of recurrent CAD and even lower rates of recurrence associated with ischemia. Further patient-level data and clinical subgroup analyses would improve the ability to provide patient-level risk stratification.

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颈动脉夹层复发：一项系统综述和荟萃分析。

背景和目的：涉及颈动脉或椎动脉的颈动脉夹层（CAD）是年轻患者中风的重要原因。本系统综述的目的是评估复发性CAD的风险。方法：对经放射学证实的颈动脉或椎动脉颅外段夹层患者的研究进行系统综述和荟萃分析，并报告了CAD复发率。结果：数据来自29项符合条件的研究（n = 5898名患者）。通过将发病率与方差倒数加权的随机效应模型合并进行结果分析。复发性CAD的总发生率为4%（95%置信区间（CI） = 3-7%），1时为2% 月（95%置信区间 = 1-5%），1时为7% 有足够随访的研究年数（95%置信区间 = 4-13%）。与缺血性事件相关的复发发生率为2%（95%CI = 1-3%）。结论：我们发现CAD的复发率较低，与缺血相关的复发率甚至更低。进一步的患者水平数据和临床亚组分析将提高提供患者水平风险分层的能力。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International Journal of Stroke 医学-外周血管病

CiteScore

13.90

自引率

6.00%

发文量

132

审稿时长

6-12 weeks

期刊介绍： The International Journal of Stroke is a welcome addition to the international stroke journal landscape in that it concentrates on the clinical aspects of stroke with basic science contributions in areas of clinical interest. Reviews of current topics are broadly based to encompass not only recent advances of global interest but also those which may be more important in certain regions and the journal regularly features items of news interest from all parts of the world. To facilitate the international nature of the journal, our Associate Editors from Europe, Asia, North America and South America coordinate segments of the journal.