Endovascular thrombectomy for severe cerebral venous thrombosis: A comprehensive meta-analysis assessing safety and efficacy.

IF 1.7 4区医学 Q3 Medicine

Interventional Neuroradiology Pub Date : 2024-09-30 DOI:10.1177/15910199241285071

Sherief Ghozy, Atakan Orscelik, Hatem Tolba, Mariam Abdelghaffar, Hassan Kobeissi, Hazem S Ghaith, Alzhraa S Abbas, Ramanathan Kadirvel, Waleed Brinjikji, David F Kallmes

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引用次数: 0

Abstract

Background: Cerebral sinus venous thrombosis (CSVT) has traditionally been treated medically with systemic anticoagulation. Recent advances in endovascular therapy (EVT) may represent an alternative treatment to medical therapy for CSVT. We conducted a systematic review and meta-analysis to evaluate the use of EVT for CSVT.

Methods: We conducted a systematic literature review using PubMed, Embase, Scopus, and Web of Science. We included studies that reported outcomes following EVT for CSVT. The primary outcome of interest was rate of modified Rankin Scale (mRS) 0-2. Secondary outcomes of interest were rates of complete, partial, and failed recanalization, mortality, and new or expansion of hematoma. We calculated pooled rates (%) and their corresponding 95% confidence intervals (CIs).

Results: Thirty-eight studies with 682 patients were included. Rate of mRS 0-2 was 82.6% (95% CI, 75.3%-88.0%). Rate of complete recanalization was 60.9% (95% CI, 49.1%-71.5%), rate of partial recanalization was 34.2% (95% CI, 24.1%-45.9%), and rate of failed recanalization was 5.4% (95% CI, 3.1%-9.2%). Rate of mortality was 6.7% (95% CI, 4.1%-10.8%), and rate of new hematoma or expansion of hematoma was 5.1% (2.9%-8.8%).

Conclusions: In this systematic review and meta-analysis, EVT for CSVT was associated with favorable rates of mRS 0-2 and recanalization. Furthermore, EVT was associated with a promising safety profile. Future prospective, comparative studies are warranted to assess EVT for CSVT.

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严重脑静脉血栓形成的血管内血栓切除术：评估安全性和有效性的综合荟萃分析。

背景：脑窦静脉血栓形成（CSVT）传统上采用全身抗凝药物治疗。血管内治疗（EVT）的最新进展可能成为 CSVT 药物治疗的替代疗法。我们进行了一项系统性回顾和荟萃分析，以评估 EVT 在 CSVT 中的应用：我们使用 PubMed、Embase、Scopus 和 Web of Science 进行了系统性文献综述。我们纳入了报告 CSVT EVT 治疗结果的研究。我们关注的主要结果是改良Rankin量表（mRS）0-2的比率。次要结果是完全、部分和失败再通畅率、死亡率以及血肿新增或扩大率。我们计算了汇总率（%）及其相应的 95% 置信区间 (CI)：结果：共纳入 38 项研究，682 名患者。mRS 0-2 的比例为 82.6%（95% CI，75.3%-88.0%）。完全再通率为 60.9%（95% CI，49.1%-71.5%），部分再通率为 34.2%（95% CI，24.1%-45.9%），失败再通率为 5.4%（95% CI，3.1%-9.2%）。死亡率为6.7%（95% CI，4.1%-10.8%），新血肿或血肿扩大率为5.1%（2.9%-8.8%）：在这项系统性回顾和荟萃分析中，CSVT的EVT与mRS 0-2和再通率相关。此外，EVT还具有良好的安全性。未来有必要开展前瞻性比较研究，评估EVT治疗CSVT的效果。

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

Interventional Neuroradiology 医学-核医学

CiteScore

2.80

自引率

11.80%

发文量

192

审稿时长

6-12 weeks

期刊介绍： Interventional Neuroradiology (INR) is a peer-reviewed clinical practice journal documenting the current state of interventional neuroradiology worldwide. INR publishes original clinical observations, descriptions of new techniques or procedures, case reports, and articles on the ethical and social aspects of related health care. Original research published in INR is related to the practice of interventional neuroradiology...