Mechanical Thrombectomy in Anticoagulated Patients With Acute Ischemic Stroke: A Meta-Analysis.

IF 1.1 4区医学 Q4 CLINICAL NEUROLOGY

Neurologist Pub Date : 2024-05-01 DOI:10.1097/NRL.0000000000000542

HaoLiang Zhang, Shiqin Chen, QianYuan Zhu, ZongShan Li, Tian Lv, Chengjiang Liu

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引用次数: 0

Abstract

Background: According to a previous studies, mechanical thrombectomy(MT) is safe for anticoagulated patients. However, the safety and prognosis of direct oral anticoagulants (DOACs) and vitamin K antagonists (VKA) have not been compared with those of MT.This meta-analysis aimed at determining the efficacy of DOACs or VKA for patients after MT.

Review summary: We searched PubMed, Embase, Web of Science databases, and Cochrane from their inception to Aug 2022. Revman 5.3 served for the meta-analysis. The meta-analysis included 12 studies that covered 3571 patients, finding that after MT treatment, DOACs significantly decreased the symptomatic intracerebral hemorrhage [odd ratio (OR)=0.49, 95% CI 0.30-0.80, P =0.004] and mortality (OR=0.63, 95% CI 0.48-0.83, P =0.001) compared with VKA. Meanwhile, no obvious differences were found between DOACs and VKA after MT treatment in terms of in any hemorrhagic transformation (OR=1.07, 95% CI 0.84-1.37, P =0.59), good functional outcome (OR=1.06, 95% CI 0.88-1.27, P =0.53), and successful arterial recanalization (OR=1.24, 95% CI 1.00-1.53, P =0.05).

Conclusions: This meta-analysis demonstrates that the application of DOACs in MT treatment for anticoagulated patients with acute ischemic stroke is safer than that in the VKA group. However, further studies are necessary to confirm these results.

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急性缺血性脑卒中抗凝患者机械取栓:荟萃分析

背景:根据以往的研究，机械取栓(MT)对抗凝患者是安全的。然而，直接口服抗凝剂(DOACs)和维生素K拮抗剂(VKA)的安全性和预后尚未与mt进行比较。这项荟萃分析旨在确定DOACs或VKA对mt后患者的疗效。综述摘要:我们检索了PubMed, Embase, Web of Science数据库和Cochrane，从他们成立到2022年8月。meta分析采用Revman 5.3。meta分析纳入12项研究，涵盖3571例患者，发现与VKA相比，MT治疗后DOACs显著降低症状性脑出血[奇比(OR)=0.49, 95% CI 0.30-0.80, P=0.004]和死亡率(OR=0.63, 95% CI 0.48-0.83, P=0.001)。同时，在MT治疗后，DOACs与VKA在任何出血转化(OR=1.07, 95% CI 0.84-1.37, P=0.59)、良好的功能结局(OR=1.06, 95% CI 0.88-1.27, P=0.53)、动脉再通成功(OR=1.24, 95% CI 1.00-1.53, P=0.05)方面均无明显差异。结论:本荟萃分析表明，DOACs在抗凝急性缺血性脑卒中患者MT治疗中的应用比VKA组更安全。然而，需要进一步的研究来证实这些结果。

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

Neurologist 医学-临床神经学

CiteScore

1.90

自引率

0.00%

发文量

151

审稿时长

2 months

期刊介绍： The Neurologist publishes articles on topics of current interest to physicians treating patients with neurological diseases. The core of the journal is review articles focusing on clinically relevant issues. The journal also publishes case reports or case series which review the literature and put observations in perspective, as well as letters to the editor. Special features include the popular "10 Most Commonly Asked Questions" and the "Patient and Family Fact Sheet," a handy tear-out page that can be copied to hand out to patients and their caregivers.