Meta-analysis of the efficacy and safety of combined arterial and venous thrombolysis in the treatment of acute ischemic stroke.

IF 1.7 4区医学 Q3 CLINICAL NEUROLOGY

Neurological Research Pub Date : 2025-04-01 DOI:10.1080/01616412.2025.2482766

Wenjun Liu, Guohui Ye, Shiqi Xie, Hai Hu

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引用次数: 0

Abstract

Objective: This study aims to evaluate the efficacy and safety of combined arterial and venous thrombolysis in the treatment of acute ischemic stroke.

Methods: Randomized controlled trials (RCTs) were systematically evaluated by comprehensive literature review and inclusion criteria. Cochrane bias risk assessment tool was used to evaluate the research quality, and RevMan 5.3 software was used for Meta-analysis. The main outcome indicators included NIHSS, MRS, recanalization rate, cerebral hemorrhage and mortality.

Results: 20 articles were finally included, including 2287 subjects, including 1096 cases in the combined group and 1191 cases in the control group, all of which were randomized controlled experiments. The improvement of NIHSS score in combined thrombolysis group was better than that in control group (OR = 1.79, p < 0.001). The improvement of mRS score in the combined thrombolysis group was better than that in the control group (OR = 1.54, p < 0.01). The recanalization rate of artery and vein combined with thrombolysis was better (OR = 2.91, p < 0.01). There was no significant difference in the risk of symptomatic cerebral hemorrhage after thrombolysis between the two groups (p > 0.05). The combined thrombolysis group had a better risk of death after thrombolysis (OR = 0.53, p < 0.01).

Conclusion: Arteriovenous thrombolysis combined with acute cerebral infarction has advantages in NIHSS, MRS and recanalization rate. However, there was no significant increase in arterial or intravenous thrombolysis for symptomatic cerebral hemorrhage. Arteriovenous combined thrombolysis may have curative effect and acceptable safety in acute ischemic stroke.

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动脉和静脉联合溶栓治疗急性缺血性脑卒中的疗效和安全性荟萃分析。

目的：评价动静脉联合溶栓治疗急性缺血性脑卒中的疗效和安全性。方法：采用综合文献复习和纳入标准对随机对照试验（RCTs）进行系统评价。采用Cochrane偏倚风险评估工具评价研究质量，采用RevMan 5.3软件进行meta分析。主要结局指标包括NIHSS、MRS、再通率、脑出血和死亡率。结果：最终纳入文献20篇，受试者2287例，其中联合组1096例，对照组1191例，均为随机对照实验。联合溶栓组NIHSS评分的改善优于对照组（OR = 1.79, p p p p > 0.05）。联合溶栓组溶栓后死亡风险较低（OR = 0.53, p）。结论：动静脉溶栓联合急性脑梗死在NIHSS、MRS、再通率方面具有优势。然而，对于有症状的脑出血，动脉溶栓和静脉溶栓没有明显增加。动静脉联合溶栓治疗急性缺血性脑卒中具有良好的疗效和安全性。

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

Neurological Research 医学-临床神经学

CiteScore

3.60

自引率

0.00%

发文量

116

审稿时长

5.3 months

期刊介绍： Neurological Research is an international, peer-reviewed journal for reporting both basic and clinical research in the fields of neurosurgery, neurology, neuroengineering and neurosciences. It provides a medium for those who recognize the wider implications of their work and who wish to be informed of the relevant experience of others in related and more distant fields. The scope of the journal includes: •Stem cell applications •Molecular neuroscience •Neuropharmacology •Neuroradiology •Neurochemistry •Biomathematical models •Endovascular neurosurgery •Innovation in neurosurgery.