Efficacy and Safety of initiating Intravenous Glycoprotein IIb/IIIa Inhibitors before acute stent Implantation in Patients with Cerebral Infarction: A Systematic Review and Meta-Analysis.

IF 1.9 4区医学 Q3 CLINICAL NEUROLOGY

World neurosurgery Pub Date : 2025-03-31 DOI:10.1016/j.wneu.2025.123955

Wulan Yang, Qingmei Han, Aa Ruhan Bai, Ya Na, Yun Qing

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引用次数: 0

Abstract

Objective: To evaluate the safety and efficacy of initiating GPI infusion prior to acute intracranial artery stent implantation.

Method: We performed a meta-analysis using RevMan software to calculate the pooled risk ratio (RR) and 95% confidence intervals (CI) to assess efficacy and safety.

Result: The systematic review and meta-analysis included 7 studies involving 1156 patients who underwent acute stent implantation. 1. Efficacy outcomes: GPI not significantly improved favorable 90-day functional outcome (P=0.05, I²=0%, CI 1.14[1.00-1.30]). GPI significantly reduced perioperative stent thrombosis (P<0.00001, I²=0%, CI 0.21[0.1-0.43]), The results did not indicate a significant advantage of glycoprotein inhibitors (GPI) in recanalization (P=0.53, I²=0%, CI 1.01[0.98-1.04]). 2. The findings showed that GPI did not result in a higher incidence of Spontaneous Intracerebral Hemorrhage (SICH) (P=0.76, I²=0%, CI 0.93[0.59-1.48]), GPI not significantly improved favorable 90-day functional outcome in patients after stenting (P=0.05, I²=0%, CI 1.14[1.00-1.30]). 3. Subgroup analysis: No statistically significant differences in recanalization (TICI≥2b) (P=0.9, I²=0%, CI 1.00[0.95 to 1.06]) and perioperative SICH (P=0.77, I²=5%, CI 1.50[1.01 to 2.22]) between the two groups ,GPI was associated with a significant reduction in the incidence of perioperative stent thrombosis (P=0.0003, I²=0%, CI 0.22[0.09-0.50]) and demonstrated an improvement in favorable clinical outcomes at 90 days after acute carotid stenting (P=0.04, I²=1%, P= 0.001, CI 1.23[0.98-1.54]).

Conclusion: The use of intravenous GPI before acute stent implantation can reduce perioperative intravascular thrombosis but does not improve patient outcomes at 90 days. The use of intravenous GPI before carotid acute stenting may enhance 90-day outcomes and reduce perioperative stent thrombosis.

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来源期刊

World neurosurgery CLINICAL NEUROLOGY-SURGERY

CiteScore

3.90

自引率

15.00%

发文量

1765

审稿时长

47 days

期刊介绍： World Neurosurgery has an open access mirror journal World Neurosurgery: X, sharing the same aims and scope, editorial team, submission system and rigorous peer review. The journal''s mission is to: -To provide a first-class international forum and a 2-way conduit for dialogue that is relevant to neurosurgeons and providers who care for neurosurgery patients. The categories of the exchanged information include clinical and basic science, as well as global information that provide social, political, educational, economic, cultural or societal insights and knowledge that are of significance and relevance to worldwide neurosurgery patient care. -To act as a primary intellectual catalyst for the stimulation of creativity, the creation of new knowledge, and the enhancement of quality neurosurgical care worldwide. -To provide a forum for communication that enriches the lives of all neurosurgeons and their colleagues; and, in so doing, enriches the lives of their patients. Topics to be addressed in World Neurosurgery include: EDUCATION, ECONOMICS, RESEARCH, POLITICS, HISTORY, CULTURE, CLINICAL SCIENCE, LABORATORY SCIENCE, TECHNOLOGY, OPERATIVE TECHNIQUES, CLINICAL IMAGES, VIDEOS