重症脑静脉血栓患者血管内取栓术的安全性和有效性:一项荟萃分析。

IF 2.6 Q2 CLINICAL NEUROLOGY
Journal of Central Nervous System Disease Pub Date : 2022-10-02 eCollection Date: 2022-01-01 DOI:10.1177/11795735221131736
Gaurav Nepal, Sanjeev Kharel, Riwaj Bhagat, Megan A Coghlan, Jayant K Yadav, Stella Goeschl, Rajan Lamichhane, Subash Phuyal, Rajeev Ojha, Gentle S Shrestha
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引用次数: 1

摘要

背景:脑静脉血栓形成(CVT)是一种罕见的血栓性疾病,传统上采用抗凝治疗。严重CVT患者亚群已接受血管内血栓切除术(EVT)治疗。尽管与严重CVT相关的估计死亡率很高,但与标准医疗管理相比,EVT治疗严重CVT的安全性和有效性只有一项随机对照试验。这方面的证据缺乏。目的:本系统综述的目的是分析所有现有文献,并获得关于EVT在重症CVT患者治疗中的作用的可靠信息。方法:本研究遵循PRISMA指南进行系统评价和荟萃分析。检索了PubMed、Embase、Google Scholar和CNKI从2007年到2021年的符合条件的研究。通过荟萃分析再通状况、随访时良好的功能结局、CVT复发、新血肿来评价EVT的安全性和有效性。从各种结果(CI)的荟萃分析中得出95%置信区间的合并比例。结果:共纳入33项研究,包括610例EVT患者,其中1项随机对照试验,1项前瞻性研究和31项回顾性研究。根据汇总的数据,85%的患者有良好的功能结果,62%的患者有完全的再通,5%的患者有全因死亡率,3%的患者有导管相关并发症。该分析的疗效结果具有显著的异质性,并进行了亚组分析来解释这些发现。最短随访时间为3个月,在整个研究中使用了各种EVT技术。结论:本荟萃分析提示EVT治疗严重CVT是安全有效的。注册:我们的方案已在PROSPERO:国际前瞻性系统评价注册中心注册,注册号为CRD42021254760。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Safety and efficacy of endovascular thrombectomy in patients with severe cerebral venous thrombosis: A meta-analysis.

Safety and efficacy of endovascular thrombectomy in patients with severe cerebral venous thrombosis: A meta-analysis.

Safety and efficacy of endovascular thrombectomy in patients with severe cerebral venous thrombosis: A meta-analysis.

Safety and efficacy of endovascular thrombectomy in patients with severe cerebral venous thrombosis: A meta-analysis.

Background: Cerebral venous thrombosis (CVT) is a rare thrombotic condition which is traditionally treated with anti-coagulation therapy. Subsets of patients with severe CVT have been treated with endovascular thrombectomy (EVT). Despite the high estimated mortality associated with severe CVT, there has been only one randomized control trial done regarding safety and efficacy of EVT in severe CVT compared to standard medical management. Evidence in this area is lacking.

Objective: The aim of this systematic review is to analyze all existing literature and generate robust information regarding the role of EVT in the management of patients with severe CVT.

Methods: This systematic review and meta-analysis followed PRISMA guideline. PubMed, Embase, Google Scholar, and CNKI were searched for eligible studies from 2007 to 2021. Safety and efficacy of EVT were evaluated by meta-analyzing recanalization status, the good functional outcome at follow-up, recurrent CVT, new hematoma. A pooled proportion with a 95% confidence interval was derived from a meta-analysis of various outcomes (CI).

Results: A total of 33 studies comprising 610 patients treated with EVT were included for analysis which comprised one randomized control trial, one prospective study and 31 retrospective studies. Based on pooled data, 85% of patients had good functional outcome, 62% had complete recanalization, 5% had all-cause mortality, and 3% had catheter related complications. The efficacy outcomes in this analysis had a significant heterogeneity and a subgroup analysis was also done to explain these findings. The minimum time of follow up was 3 months and varied EVT techniques were used across the studies.

Conclusion: This meta-analysis suggests EVT may be safe and efficacious in treating patients with severe CVT.

Registration: Our protocol was registered with PROSPERO: International prospective register of systematic reviews with the registration number CRD42021254760.

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CiteScore
6.90
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