Cerebrovascular Diseases最新文献

{"title":"Posterior Cerebral Artery Involvement in Paediatric Moyamoya: Angiographic Patterns and Stroke Burden.","authors":"Salvatore Mazzotta, Gerasimos Baltsavias, Monika Hebeisen, Nadia Khan","doi":"10.1159/000545320","DOIUrl":"10.1159/000545320","url":null,"abstract":"<p><strong>Introduction: </strong>The posterior circulation is frequently overlooked when managing patients with moyamoya angiopathy, particularly the non-Asian population. This study aimed to identify the presence of angiopathy in the posterior cerebral artery (PCA), its patterns, and the consequences thereof in a paediatric cohort.</p><p><strong>Methods: </strong>Retrospective clinical data, MRI scans, and cerebral angiograms of all patients referred to a single centre for cerebral revascularization were analysed for PCA involvement. Angiographic patterns of PCA involvement were defined. Associated stroke burden was evaluated using general estimation equation regression models adjusting for prespecified potential confounder age at onset, right or left laterality, and involvement of anterior circulation.</p><p><strong>Results: </strong>PCA involvement was observed in 37% of 122 patients and was identified to be either proximal (proximal P1 segment, P1-posterior communicating artery [Pcomm] segment) or distal (Pcomm-P2 segment and distal P2 segment and beyond). Distal P2 (32%) and involvement of the entire PCA (26%) were most frequently observed. The odds of having any stroke (anterior distribution, i.e., anterior cerebral artery, middle cerebral artery, or posterior distribution, i.e., PCA) was five times higher (odds ratio [OR] 5.0, 95% CI [2.3, 10.9], p < 0.0001) when PCA was involved compared to without PCA involvement. Distal PCA involvement was observed in 59% of children <2 years of age. The OR of stroke in the PCA distribution with distal PCA involvement compared to proximal involvement was 4.1 (95% CI [0.9, 19.0], p = 0.07). The OR of anterior distribution stroke with Pcomm involvement versus no Pcomm involvement was 6.2 (95% CI [1.0, 37.2], p = 0.05).</p><p><strong>Conclusion: </strong>Involvement of the PCA in moyamoya children is highlighted. This may be proximal, distal, or along the entire course of the PCA and is strongly associated with overall stroke. The odds of PCA territory strokes is higher with distal PCA involvement, while involvement of the Pcomm plays a more important role in anterior stroke. Younger children are at higher risk of PCA stroke.</p>","PeriodicalId":9683,"journal":{"name":"Cerebrovascular Diseases","volume":" ","pages":"1-8"},"PeriodicalIF":2.2,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12060807/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143669221","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Impact of Abnormal Distribution of Abdominal Adiposity and Skeletal Muscle on the Prognosis of Ischemic Stroke.","authors":"Chengcheng Cui, Zhiwen Geng, Haotao Li, Rui Li, Mengxia Lu, Yuqiao Wang, Lulu Xiao, Xinfeng Liu","doi":"10.1159/000545334","DOIUrl":"10.1159/000545334","url":null,"abstract":"<p><strong>Introduction: </strong>This study aimed to investigate the role of novel indicators related to obesity in predicting long-term functional outcomes and the risk of stroke recurrence in participants with first-ever acute ischemic stroke (AIS).</p><p><strong>Methods: </strong>The area and density of visceral adipose tissue (VAT), subcutaneous adipose tissue (SAT), and skeletal muscle (SM) at the third lumbar level, as well as the VAT area (VATA)-to-SM area (SMA) ratio (VSR) and the SAT area-to-SMA ratio (SSR) were assessed using whole-abdominal computerized tomography upon admission. The primary endpoint was the recurrence of stroke. The secondary outcomes were all-cause mortality and cardio-cerebrovascular origin death (CCVD) specifically due to cardiovascular and cerebrovascular diseases. Cox's proportional hazards regression model was used to examine the associations between the novel indicators of obesity and clinical outcomes.</p><p><strong>Results: </strong>A total of 1,007 participants were enrolled, with an average follow-up time of 1,445 days. The participants in the high VSR group had a higher rate of stroke recurrence {adjusted hazard ratio, 2.06 (95% confidence interval [CI], 1.35-3.14); p = 0.001}. According to the adjusted analysis, high VSR was significantly associated with an increased risk of all-cause mortality (hazard ratio, 2.26 [95% CI, 1.58-3.24]; p < 0.001) and CCVD (hazard ratio, 2.49 [95% CI, 1.65-3.78]; p < 0.001).</p><p><strong>Conclusion: </strong>A higher VSR was associated with a higher risk of mortality and stroke recurrence in participants with first-ever AIS.</p>","PeriodicalId":9683,"journal":{"name":"Cerebrovascular Diseases","volume":" ","pages":"1-12"},"PeriodicalIF":2.2,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143662305","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Outcomes following Acute Ischaemic Stroke in Patients with Comorbid Cancer.","authors":"Noriko Sato, Fumi Kiyuna, Kayo Wakisaka, Yuichiro Ohya, Kana Ueki, Sohei Yoshimura, Kuniyuki Nakamura, Jun Hata, Yoshinobu Wakisaka, Tetsuro Ago, Masahiro Kamouchi, Takanari Kitazono, Ryu Matsuo","doi":"10.1159/000544700","DOIUrl":"10.1159/000544700","url":null,"abstract":"<p><strong>Introduction: </strong>The prevalence of comorbid cancer is higher in patients with ischaemic stroke than in the general population, and recent studies have attempted to clarify the relationship between the two. We observed that the evidence for the impact of comorbid cancer on post-stroke clinical outcomes was not established and aimed to investigate it among patients with new-onset acute ischaemic stroke.</p><p><strong>Methods: </strong>We evaluated 13,345 patients with acute ischaemic stroke who were functionally independent before onset (modified Rankin Scale [mRS] score of 0-2) and admitted to one of the seven stroke centres in Fukuoka, Japan, between June 2007 and September 2019. A total of 13,047 patients were included in the analyses after excluding those with missing potential confounders (n = 13) or loss to follow-up (n = 298). Comorbid cancer was diagnosed based on previous history or newly identified cancer during hospitalisation for the index stroke. Multivariable-adjusted Poisson regression analyses were conducted to assess the association of comorbid cancer with post-stroke outcomes: clinically assessed poor functional outcomes (mRS score, 3-6), functional dependency (mRS score, 3-5), and mortality (mRS score, 6) at 3 months after stroke onset.</p><p><strong>Results: </strong>Of 13,047 patients (aged 71.1 ± 12.3 years, 62.8% men) with acute ischaemic stroke, 2,027 (15.6%) had comorbid cancer. Among those with no cancer, 24.0% recorded poor functional outcomes; with non-active cancer, 30.7%; and with active cancer, 46.1%. The risk ratios (95% confidence interval) for poor functional outcome at 3 months increased with active cancer (1.50 [1.37-1.65] vs. no cancer) and recently diagnosed cancer (7 months-4 years: 1.43 [1.28-1.59], ≤6 months: 1.53 [1.36-1.72]) after adjusting for potential confounders. These associations were observed for both 3-month functional dependency and mortality. No significant heterogeneity was observed in these associations across sex, nutritional status, inflammatory status, or coagulation status, except for age and stroke severity. The strongest association with 3-month poor functional outcome was observed for pancreatic cancer, followed by gallbladder and biliary tract, liver, and colon cancers.</p><p><strong>Conclusions: </strong>Comorbid cancer is likely to be independently associated with unfavourable outcomes in patients with acute ischaemic stroke.</p>","PeriodicalId":9683,"journal":{"name":"Cerebrovascular Diseases","volume":" ","pages":"1-9"},"PeriodicalIF":2.2,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143662298","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Stroke Medicine Is Frailty Medicine: Clinical and Research Priorities for Frailty in Stroke.","authors":"Nicholas R Evans, Jatinder S Minhas, Lucy C Beishon, Terence J Quinn","doi":"10.1159/000545288","DOIUrl":"10.1159/000545288","url":null,"abstract":"","PeriodicalId":9683,"journal":{"name":"Cerebrovascular Diseases","volume":" ","pages":"1-8"},"PeriodicalIF":2.2,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143639561","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Body Mass Index on Outcome of Endovascular Thrombectomy with or without Intravenous Alteplase in Acute Stroke in China: A Post Hoc Analysis of DIRECT-MT Trial.","authors":"Qingyuan Wu, Xiangyu Chen, Yina Wu, Limin Ma, Yongpin Chen, Wenqing Zhang, Rong Deng, Jin Liu, Lei Zhang, Zifu Li, Pengfei Xing, Yongwei Zhang, Pengfei Yang, Yue Liu, Peng Xie, Lijun Wang, Shengli Chen, Jianmin Liu","doi":"10.1159/000544907","DOIUrl":"10.1159/000544907","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;The impact of body mass index (BMI) on outcomes after mechanical thrombectomy (MT) for large vessel occlusion acute ischemic stroke (LVOS) has been a subject of controversy, mainly due to the so-called obesity paradox. The obesity paradox refers to the phenomenon where, contrary to expectations, overweight or obese individuals seem to have better clinical outcomes in certain disease states. This study aimed to investigate the relationship between BMI and the clinical prognosis of patients with LVOS treated with endovascular thrombectomy (EVT) combined with or without intravenous alteplase in DIRECT-MT (Direct Intra-arterial Thrombectomy to Revascularize Acute Ischemic Stroke Patients with Large Vessel Occlusion Efficiently in Chinese Tertiary Hospitals: A Multicenter Randomized Clinical Trial).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This is a post hoc analysis of the DIRECT-MT randomized trial. Patients were randomly allocated to undergo EVT after alteplase intravenous thrombolysis (IVT) (IVT+EVT group) or EVT alone (EVT group) at a 1:1 ratio. Among 656 randomized patients, 645 with baseline BMI information were included. The BMI was analyzed as a categorical variable, and all patients were categorized according to their BMI into 3 groups: 18.5 ≤ BMI &lt;24 kg/m2 (normal weight), 24 ≤ BMI &lt;28 kg/m2 (overweight), and BMI ≥28 kg/m2 (obese). The primary outcome was the 90-day modified Rankin Scale (mRS) score analyzed as a continuous variable. Multivariable ordinal logistic regression with an interaction term was used to estimate treatment allocation and the BMI subgroups.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 645 patients were enrolled in this study, 373 (57.8%) were normal weight, 208 (32.2%) were overweight, and 64 (10.0%) were obese. In all, 175 (46.9%) normal-weight patients, 114 (54.8%) overweight patients, and 31 (48.4%) obese patients underwent direct EVT. Patients in the three groups were statistically different in age (71 versus 68, 66), time from randomization to groin puncture (31 versus 32, 39.5), time from randomization to revascularization (101.5 versus 92, 116), and time from admission to groin puncture (84 versus 83, 98.5). Other baseline and procedural characteristics were comparable. No significant difference for the ordinal mRS or 90-day mortality was observed by BMI (adjusted common odds ratio [acOR] was 0.92 [95% CI 0.64 to 1.32] for normal weight, 1.36 [95% CI 0.83 to 2.22] for overweight, and 1.09 [95% CI 0.45 to 2.64] for obese) and treatment allocation interaction (the adjusted p value for interaction was 0.335 [normal weight versus overweight], 0.761 [normal weight versus obese], and 0.733 [overweight versus obese]). For the procedural complications and other clinical and imaging outcomes, no significant differences were observed between the BMI and treatment allocation.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;The results demonstrated that BMI had no association with the final outcome whether the pa","PeriodicalId":9683,"journal":{"name":"Cerebrovascular Diseases","volume":" ","pages":"1-12"},"PeriodicalIF":2.2,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143540366","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk Factors for Incomplete Occlusion in Patients with Small Intracranial Aneurysms (&lt;7 mm) after Flow-Diversion Treatment: A Multicenter Experience.","authors":"Chi Huang, Xingwei Lei, Xin Feng, Xin Tong, Zhuohua Wen, Jiancheng Lin, Mengshi Huang, Chao Peng, Tao Wang, Wenxin Chen, Lele Dai, Xin Jin, Shixing Su, Xin Zhang, Xifeng Li, Zongduo Guo, Aihua Liu, Chuanzhi Duan","doi":"10.1159/000544991","DOIUrl":"10.1159/000544991","url":null,"abstract":"<p><strong>Introduction: </strong>The indicator of flow diverters (FDs) received approval extension for small (<7 mm) unruptured intracranial aneurysms (UIAs). However, the factors related to aneurysm occlusion remain unclear. Thus, we conducted a multicenter analysis to explore the risk factors for incomplete occlusion (ICO) following FD implantation for small UIAs.</p><p><strong>Methods: </strong>We retrospectively reviewed patients from 5 comprehensive hospitals in China with small UIAs treated with either Pipeline or Tubridge between September 2018 and September 2022. Baseline data were prospectively collected at admission. The relationship between baseline characteristics and occlusion status was analyzed, and multivariate logistic regression models were performed to identify the independently related factors.</p><p><strong>Results: </strong>A total of 565 patients with 565 small UIAs were enrolled. During a mean angiographic follow-up of 10.64 ± 5.99 months, ICO was detected in 116 cases (20.5%). After adjusting for candidate variables, hypertension (adjusted odds ratio [aOR] = 2.274, 95% confidence interval [CI] = 1.462-3.538, p < 0.001), coronary disease (aOR = 2.742, 95% CI = 1.148-6.552, p = 0.023), larger aneurysm size (aOR = 1.833, 95% CI = 1.425-2.356, p < 0.001), lower size ratio (SR, aOR = 0.380, 95% CI = 0.166-0.869, p = 0.022), and less coil application (aOR = 0.212, 95% CI = 0.061-0.741, p = 0.015) were independently associated with ICO of small UIAs.</p><p><strong>Conclusion: </strong>Hypertension, coronary disease, larger aneurysm size, lower SR, and less coil application were independent predictors of ICO for small UIAs after FD implantation. Neurointerventionalists should focus more on blood pressure management and aneurysm morphological assessment in flow-diversion treatment for small UIAs.</p>","PeriodicalId":9683,"journal":{"name":"Cerebrovascular Diseases","volume":" ","pages":"1-8"},"PeriodicalIF":2.2,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143540368","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Frailty in Stroke.","authors":"Jatinder S Minhas, Terence J Quinn, Nicholas R Evans, Lucy C Beishon","doi":"10.1159/000545033","DOIUrl":"10.1159/000545033","url":null,"abstract":"","PeriodicalId":9683,"journal":{"name":"Cerebrovascular Diseases","volume":" ","pages":"1-2"},"PeriodicalIF":2.2,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143540364","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Nationwide Prospective Registry of Endovascular Thrombectomy for Extra-Large Ischemic Stroke with Large Vessel Occlusion (XL STROKE): Rationale and Design.","authors":"Guangxiong Yuan, Lei Liu, Yong Liang, Junxiong Wu, Thanh N Nguyen, Shuai Wei, Tao Cui, Xiangdong Li, Zhengzhou Yuan, Shudong Liu, Guoyong Zeng, Zhongfan Ruan, Chong Zheng, Xiaolin Tan, Songlin Tang, Haizhen Hao, Haiyan Xia, Raul G Nogueira, Götz Thomalla, Bruce Campbell, Jeffrey L Saver, Qingwu Yang, Chen Long, Zhongming Qiu, Hongfei Sang","doi":"10.1159/000544844","DOIUrl":"10.1159/000544844","url":null,"abstract":"<p><strong>Introduction: </strong>The role of endovascular thrombectomy (EVT) for acute extra-large ischemic stroke patients with large vessel occlusion (LVO) is uncertain. We aimed to explore the clinical and safety outcomes of medical management (MM) plus EVT (EVT group) versus MM alone (MM group) among acute extra-large ischemic stroke patients with LVO within 24 h of last known well.</p><p><strong>Methods: </strong>XL STROKE (EVT for extra-large ischemic stroke) is an investigator-initiated, nationwide, prospective registry with blinded end point assessment performed at approximately 60 sites in China and will enroll up to 990 acute ischemic stroke patients within 24 h of last known well. Imaging inclusion criteria are occlusion of the internal carotid artery or the middle cerebral artery M1 or M2 segments, and Alberta Stroke Program Early Computed Tomography Score of 0 to 2 or an ischemic core volume ≥85 mL. All patients will be dichotomized into EVT group and MM group according to whether they received EVT or not. The primary outcome is the level of disability on the modified Rankin Scale at 90 ± 14 days. Safety outcomes include symptomatic intracranial hemorrhage within 48 h and mortality at 90 ± 14 days.</p><p><strong>Conclusion: </strong>Results from XL STROKE registry will provide constructive evidence of improved disability outcomes and safety with EVT for acute extra-large ischemic stroke patients with LVO within 24 h of last known well.</p>","PeriodicalId":9683,"journal":{"name":"Cerebrovascular Diseases","volume":" ","pages":"1-7"},"PeriodicalIF":2.2,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143499672","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Prediction of Hematoma Growth in Acute Intracerebral Hemorrhage: From 2-Dimensional Shape to 3-Dimensional Morphology.","authors":"Wen-Song Yang, Yi-Qing Shen, Qing-Jun Liu, Yong-Bo Ma, Jun-Meng Huang, Qing-Yuan Wu, Jing Wang, Chao-Yi Huang, Li-Bo Zhao, Qi Li, Peng Xie","doi":"10.1159/000544757","DOIUrl":"10.1159/000544757","url":null,"abstract":"<p><strong>Introduction: </strong>The relationship between the 3-dimensional morphological features of hematoma and hematoma growth (HG) remains unclear. We aimed to quantitatively assess the predictive value of 3-dimensional hematoma morphology for HG among patients with intracerebral hemorrhage (ICH).</p><p><strong>Methods: </strong>Our study comprised 312 consecutive ICH patients. Using semi-automated volumetric analysis software, we measured hematoma volumes and delineated the region of interest. We employed Python software to extract shape features and receiver operating characteristic curve analysis to assess the predictive performance of hematoma morphology for HG. p < 0.05 was considered statistically significant.</p><p><strong>Results: </strong>Sphericity and SurfaceArea emerged as the most effective 3-dimensional hematoma morphological predictors for HG. Optimal cutoff points relating to HG were Sphericity ≤0.56 and SurfaceArea >55 cm2. We subsequently constructed the 3-dimensional morphology models, including the probability of hematoma morphology (PHM) and the probability of comprehensive model (PCM), to predict HG. The PHM model outperformed the irregular hematoma (p = 0.007), island sign (p = 0.032), and satellite sign (p < 0.001) in predictive accuracy for HG. Among all prediction models, the PCM presented the highest predictive value for active bleeding.</p><p><strong>Conclusions: </strong>The Sphericity ≤0.56 and SurfaceArea >55 cm2 could represent the optimal threshold for HG prediction. PHM was considered a reliable 3-dimensional morphology model for HG prediction. PCM tended to be a better model for risk stratification of active bleeding in acute ICH patients.</p>","PeriodicalId":9683,"journal":{"name":"Cerebrovascular Diseases","volume":" ","pages":"1-11"},"PeriodicalIF":2.2,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143448319","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of Acupuncture on Dysphagia after Stroke: A Meta-Analysis and Trial Sequential Analysis of Randomized Controlled Trials.","authors":"Jiongliang Zhang, Minmin Wu, Xinyue Li, Donghui Yu, Huanhuan Jia, Binhan Wang, Yuting Wang, Yumeng Su, Xiangyu Wei, Luwen Zhu","doi":"10.1159/000544743","DOIUrl":"10.1159/000544743","url":null,"abstract":"<p><strong>Introduction: </strong>Poststroke dysphagia (PSD) is a highly prevalent dysfunction after stroke, characterized by high mortality and seriously affecting the quality of life of patients. Previous studies have shown that acupuncture improves symptoms of PSD. However, repeated tests of significance may exaggerate type I errors. The aim of the study was to update the evidence on the effectiveness and safety of acupuncture for PSD using a meta-analysis and trial sequential analysis (TSA).</p><p><strong>Methods: </strong>A comprehensive search of PubMed, Embase, Cochrane Library, and Web of Science was conducted to identify randomized controlled trials evaluating the effects of acupuncture on PSD. Trials published up to September 15, 2024, meeting the predetermined inclusion criteria, were included.</p><p><strong>Results: </strong>Twenty studies involving 1,718 participants were included. Combined acupuncture with rehabilitation therapies significantly improved the Standard Swallowing Assessment (mean difference [MD] = -3.64, 95% confidence interval [CI]: -4.72 to -2.56, p < 0.0001), Video Fluoroscopic Swallowing Study scale (MD = 1.49, 95% CI: 0.89 to 2.09, p < 0.0001), Water Swallow Test (MD = -0.72, 95% CI: -0.96 to -0.47, p < 0.0001), and Swallowing Quality of Life Questionnaire (MD = 16.56, 95% CI: 9.94 to 23.18, p < 0.0001). TSA indicated that the sample size exceeded the required information size. In addition, acupuncture showed safety for PSD treatment (relative ratio = 1.23, 95% CI: 0.70 to 2.17, p = 0.48); however, the sample size was insufficient.</p><p><strong>Conclusions: </strong>TSA demonstrated the positive effects of acupuncture on swallowing function in patients with PSD. Nonetheless, high-quality trials are needed to validate the safety of acupuncture.</p>","PeriodicalId":9683,"journal":{"name":"Cerebrovascular Diseases","volume":" ","pages":"1-21"},"PeriodicalIF":2.2,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143448305","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}