Contrast extravasation and outcome of endovascular therapy in acute ischaemic stroke: a systematic review and meta-analysis.
Contrast extravasation and outcome of endovascular therapy in acute ischaemic stroke: a systematic review and meta-analysis.
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急性缺血性卒中血管内治疗的对比外渗和结果：系统评价和荟萃分析
DOI：
10.1136/bmjopen-2020-044917
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发表时间：
2021-07-07
期刊：
影响因子：
2.9
通讯作者：
Luo H
中科院分区：
文献类型：
--
作者：
Xu T;Wang Y;Yuan J;Chen Y;Luo H
目的血管内治疗(EVT)后造影剂外渗(CE)常见于急性缺血性卒中(AIS)患者。在AIS患者中，CE与EVT结果之间的关系仍然存在很大的不确定性。因此，我们的目标是评估这种关联。设计：对已发表的研究进行系统综述和荟萃分析。资料来源：我们系统地检索Medline和Embase数据库中的相关临床研究。最后一次在数据库中进行文献搜索是在2020年6月。研究选择的资格标准我们纳入了探讨接受EVT的AIS患者的CE和EVT结果之间的相关性的研究。资料提炼与综合两位评审员分别从每篇文章中独立提取相关信息和数据。我们使用随机效应荟萃分析将OR与顺式疗法合并，以计算CE与EVT结果之间的关联。估计之间的异质性的大小用I2统计量来量化，具有95%的顺应性。结果共纳入15项观察性研究，共纳入1897例患者。CE患者出院时发生功能不良的风险较高(2.38，95%CI1.45~3.89p=0.001；n=5 45)，90天功能不良的风险较高(OR2.16，95%CI1.2 0~3.9 0；n=1 194)。我们未发现CE与EVT后住院死亡率(OR 0.95，95%CI 0.27~3.30；n=376)或90天死亡率(OR 1.38，95%CI 0.81~2.36；n=697)之间的相关性。此外，CE与EVT后颅内出血(OR 6.68，95%CI 3.51~12.70；n=1721)和症状性ICH(OR 3.26，95%CI 1.97~5.40；n=1092)相关。结论这项系统回顾和荟萃分析表明，在接受EVT的AIS患者中，CE与不良功能结局和脑出血的风险较高。因此，对行EVT的AIS患者应给予更多的关注。
Objective Contrast extravasation (CE) after endovascular therapy (EVT) is commonly present in acute ischaemic stroke (AIS) patients. Substantial uncertainties remain about the relationship between CE and the outcomes of EVT in patients with AIS. Therefore, we aimed to evaluate this association. Design A systematic review and meta-analysis of published studies were performed. Data source We systematically searched the Medline and Embase databases for relevant clinical studies. The last literature search in databases was performed in June 2020. Eligibility criteria for study selection We included studies exploring the associations between CE and the outcomes of EVT in patients with AIS undergoing EVT. Data extraction and synthesis Two reviewers extracted relevant information and data from each article independently. We pooled ORs with CIs using a random-effects meta-analysis to calculate the associations between CE and outcomes of EVT. The magnitude of heterogeneity between estimates was quantified with the I2 statistic with 95% CIs. Results Fifteen observational studies that enrolled 1897 patients were included. Patients with CE had higher risks of poor functional outcome at discharge (2.38, 95% CI 1.45 to 3.89 p=0.001; n=545) and poor functional outcome at 90 days (OR 2.16, 95% CI 1.20 to 3.90; n=1194). We found no association between CE and in-hospital mortality (OR 0.95, 95% CI 0.27 to 3.30; n=376) or 90-day mortality (OR 1.38, 95% CI 0.81 to 2.36; n=697) after EVT. Moreover, CE was associated with higher risks of post-EVT intracranial haemorrhage (ICH) (OR 6.68, 95% CI 3.51 to 12.70; n=1721) and symptomatic ICH (OR 3.26, 95% CI 1.97 to 5.40; n=1092). Conclusions This systematic review and meta-analysis indicates that in patients with AIS undergoing EVT, CE is associated with higher risks of unfavourable functional outcomes and ICH. Thus, we should pay more attention to CE in patients with AIS undergoing EVT.
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影响因子：
4
作者：
von Hippel PT
通讯作者：
von Hippel PT
影响因子：
8.3
作者：
Shi ZS;Liebeskind DS;Loh Y;Saver JL;Starkman S;Vespa PM;Gonzalez NR;Tateshima S;Jahan R;Feng L;Miller C;Ali LK;Ovbiagele B;Kim D;Duckwiler GR;Viñuela F;UCLA Endovascular Stroke Therapy Investigators
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影响因子：
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Xu, C.;Zhou, Y.;Lou, M.
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