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dc.contributor.authorDmytriw, Adam A-
dc.contributor.authorPhan, Kevin-
dc.contributor.authorMaingard, Julian T-
dc.contributor.authorMobbs, Ralph J-
dc.contributor.authorBrooks, Duncan Mark-
dc.contributor.authorChen, Karen-
dc.contributor.authorYang, Victor-
dc.contributor.authorKok, Hong Kuan-
dc.contributor.authorHirsch, Joshua A-
dc.contributor.authorBarras, Christen D-
dc.contributor.authorChandra, Ronil V-
dc.contributor.authorAsadi, Hamed-
dc.identifier.citationNeuroradiology 2020; 62(7): 861-866-
dc.description.abstractStrokes associated with cervical artery dissection have been managed primarily with antithrombotics with poor outcomes. The additive role of endovascular thrombectomy remains unclear. The objective was to perform systematic review and meta-analysis to compare endovascular thrombectomy and medical therapy for acute ischemic stroke associated with cervical artery dissection. Studies from six electronic databases included outcomes of patient cohorts with acute ischemic stroke secondary to cervical artery dissection who underwent treatment with endovascular thrombectomy. A meta-analysis of proportions was conducted with a random effects model. Modified Rankin score at 90 days (mRS 0-2) was the primary outcome. Other outcomes included proportion of patients with thrombolysis in cerebral infarction (TICI) 2b-3 flow, 90-day mortality rate, and 90-day symptomatic intracerebral hemorrhage (sICH) rate. Six studies were included, comprising 193 cases that underwent thrombectomy compared with 59 cases that were managed medically. Successful recanalization with a pooled proportion of thrombolysis in cerebral infarction (TICI) 2b-3 flow in the thrombectomy group was 74%. Favorable outcome (mRS 0-2) was superior in the pooled thrombectomy group (62.9%, 95% CI 55.8-69.5%) compared with medical management (41.5%, 95% CI 29.0-55.1%, P = 0.006). The pooled rate of 90-day mortality was similar for endovascular vs medical (8.6% vs 6.3%). The pooled rate of symptomatic intracranial haemorrhage (sICH) did not significantly differ (5.9% vs 4.2%, P = 0.60). Current data suggest that endovascular thrombectomy may be an option in patients with acute ischemic stroke due to cervical artery dissection. This requires further confirmation in higher quality prospective studies.-
dc.subjectImage-guided procedures-
dc.subjectVascular disease-
dc.titleEndovascular thrombectomy for tandem acute ischemic stroke associated with cervical artery dissection: a systematic review and meta-analysis.-
dc.typeJournal Article-
dc.identifier.affiliationDepartments of Medical Imaging & Surgery, Sunnybrook Health Sciences Centre, University of Toronto, 263 McCaul St, Toronto, ON, M5T 1W7, Canada-
dc.identifier.affiliationNeurointerventional Radiology, Massachusetts General Hospital, Boston, MA, USAen
dc.identifier.affiliationThe South Australian Health and Medical Research Institute, The University of Adelaide, Adelaide, South Australia, Australiaen
dc.identifier.affiliationDepartment of Radiology, Interventional Radiology Service, Northern Health, Melbourne, Australiaen
dc.identifier.affiliationNeurointerventional Radiology, Brigham and Women's Hospital, Boston, MA, USAen
dc.identifier.affiliationInterventional Neuroradiology Service, Department of Radiology, Austin Health, Heidelberg, Victoria, Australiaen
dc.identifier.affiliationFlorey Institute of Neuroscience and Mental Health, University of Melbourne, Heidelberg, Victoria, Australiaen
dc.identifier.affiliationSouthwest Sydney Clinical School, University of New South Wales, Sydney, Australiaen
dc.identifier.affiliationLiverpool Hospital, Liverpool, Australiaen
dc.identifier.affiliationDepartment of Radiology, Austin Health, Heidelberg, Victoria, Australiaen
dc.identifier.affiliationInterventional Neuroradiology Unit, Monash Imaging, Monash Health, Melbourne, Victoria, Australiaen
dc.identifier.affiliationDepartment of Imaging, Monash University, Clayton, Victoria, Australiaen
dc.identifier.affiliationDepartments of Medical Imaging & Surgery, Sunnybrook Health Sciences Centre, University of Toronto, 263 McCaul St, Toronto, ON, M5T 1W7, Canada-
dc.type.austinJournal Article-, Hamed-
item.openairetypeJournal Article-
item.fulltextNo Fulltext-
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