Endovascular therapy for acute XXXX : a systematic review and meta-analysis of randomized trials.

@entity1 @entity64 @entity23 @entity432 @entity1779 @entity34
AIMS: Evidence from @entity23 ( @entity23 ) evaluating possible benefits of @entity34 ( @entity34 ) for acute @entity64 has shown conflicting results. The purpose of this meta-analysis was to systematically examine clinical outcomes in @entity23 comparing the use of intravenous (IV) fibrinolysis alone to IV fibrinolysis plus @entity34 , for the treatment of acute @entity64 . METHODS AND RESULTS: We selected English language @entity23 , comparing @entity34 plus IV tissue-type plasminogen activator (tPA) (if eligible) with IV tPA alone in eligible @entity1 for the treatment of acute @entity64 . The primary endpoint was good functional outcome [modified Rankin Scale (mRS) of 0-2]. Other major endpoints of interest were all-cause mortality and symptomatic @entity1779 (sICH). The meta-analysis included 8 @entity23 that randomized 2423 @entity1 with large-vessel, anterior-circulation @entity64 . @entity34 significantly improved the rate of functional independence (90-day mRS of 0-2) when compared with IV fibrinolysis [odds ratio (OR) 1.73, 95% confidence interval (CI) 1.18-2.53, number needed to treat (NNT) = 9.3]. The all-cause mortality was lower with @entity34 compared with the control group; however, the result did not reach statistical significance (OR 0.89, 95% CI 0.68-1.15). The rate of sICH was not higher with @entity34 (OR 1.07, 95% CI 0.73-1.56). Analyses from only the recent trials (reported in 2014-15) showed further benefit (OR of mRS 0-2: 2.42, 95% CI 1.91-3.08, NNT = 5) with similar safety results. CONCLUSION: In centres with advanced systems of @entity64 care, @entity34 significantly improved functional outcomes (without compromising safety) in @entity1 with acute @entity64 due to anterior circulation, large @entity432 , compared with standard therapy.
