Brain and behavior
Bridging Thrombolysis Versus Direct Endovascular Thrombectomy in Acute Ischemic Stroke Patients With ASPECTS ≤5: A Meta-Analysis
By Wang S, Wu B, Liu F and 1 others.
Abstract
Background
Endovascular thrombectomy (EVT) is a standard treatment for acute ischemic stroke (AIS) caused by large vessel occlusion (LVO). However, the efficacy and safety of bridging thrombolysis (BT) compared to direct EVT (dEVT) remain controversial, particularly in patients with large core infarcts (Alberta stroke program early CT score [ASPECTS] ≤5). This meta-analysis aimed to compare the efficacy and safety of BT versus dEVT in this population.
Methods
We systematically searched PubMed, Embase, and Web of Science from January 1, 2010, to September 21, 2024, for studies comparing BT and dEVT in AIS patients with ASPECTS ≤5. Outcomes included functional outcomes (mRS 0-2 and 0-3), intracranial hemorrhage (ICH), symptomatic ICH (sICH), 90-day mortality, and successful reperfusion. Data were pooled using random-effects models.