Kobeissi Hassan, Liu Michael, Ghozy Sherief, Kadirvel Ramanathan, Kallmes David F
367854College of Medicine, Central Michigan University, Mt. Pleasant, MI, USA.
Department of Neurology, 6915Mayo Clinic, Rochester, MN, USA.
Interv Neuroradiol. 2022 Aug 17;30(1):15910199221121378. doi: 10.1177/15910199221121378.
Young patients experience acute ischemic stroke (AIS) at much lower rates than their older counterparts. We performed a systematic review and meta-analysis to assess the question regarding outcomes and clinical characteristics of young stroke patients who underwent mechanical thrombectomy for AIS.
Following PRISMA guidelines, a systematic review of the literature was conducted using the databases PubMed, MEDLINE, and Embase. The primary outcome of interest was 90-day modified Rankin Scale (mRS) 0-2. Secondary outcome variables included rate of successful reperfusion (TICI 2b/3), symptomatic intracerebral hemorrhage (sICH), and mortality. Using R software version 4.1.2, we calculated pooled event rates and their corresponding 95% confidence intervals (CI) for all outcomes.
Our analysis included eight studies with a total of 1903 patients. Definitions of young patients included age ranges of 18-49/50 years, 18-54/55 years, and 18-64/65 years. Functional independence was achieved in 62.0% of the patients, with an overall mortality of 9.0%. Moreover, successful reperfusion was achieved in 82.0% of the patients with sICH rates of 5.7%. There was significant heterogeneity among different analyses, which could not be attributed to the differences of the definition of young patients.
Following mechanical thrombectomy for AIS, patients aged 18-65 years achieved relatively high rates of functional independence and successful reperfusion and low rates of mortality and sICH. In this systematic review and meta-analysis of eight studies, we examined outcomes in young stroke patients, aged 18-65 years old, following mechanical thrombectomy for acute ischemic stroke. We found that young patients achieved high rates of functional independence, high rates of successful reperfusion, and low rates of mortality and symptomatic intracerebral hemorrhage.While there have been several papers examining outcomes following mechanical thrombectomy for acute ischemic stroke in young patients, the results of these studies have yet to be pooled together in a meta-analysis. Our results indicate that young patients have good outcomes following mechanical thrombectomy. Further studies that examine these outcomes are warranted so that a higher-powered analysis can be performed to better informed clinicians regarding outcomes in this patient age-group cohort.
年轻患者发生急性缺血性卒中（AIS）的几率远低于老年患者。我们进行了一项系统评价和荟萃分析，以评估接受AIS机械取栓术的年轻卒中患者的预后及临床特征。
按照PRISMA指南，使用PubMed、MEDLINE和Embase数据库对文献进行系统评价。主要关注的结局是90天改良Rankin量表（mRS）评分为0-2。次要结局变量包括成功再灌注率（脑梗死溶栓分级2b/3级）、症状性脑出血（sICH）和死亡率。使用R软件4.1.2版本，我们计算了所有结局的合并事件发生率及其相应的95%置信区间（CI）。
我们的分析纳入了8项研究，共1903例患者。年轻患者的定义包括年龄范围为18-49/50岁、18-54/55岁和18-64/65岁。62.0%的患者实现了功能独立，总体死亡率为9.0%。此外，82.0%的患者实现了成功再灌注，sICH发生率为5.7%。不同分析之间存在显著异质性，这不能归因于年轻患者定义的差异。
AIS机械取栓术后，18-65岁的患者实现功能独立和成功再灌注的比例相对较高，死亡率和sICH发生率较低。在这项对8项研究的系统评价和荟萃分析中，我们研究了18-65岁年轻卒中患者急性缺血性卒中机械取栓术后的结局。我们发现年轻患者实现功能独立的比例高、成功再灌注率高、死亡率和症状性脑出血发生率低。虽然有几篇论文研究了年轻患者急性缺血性卒中机械取栓术后的结局，但这些研究结果尚未汇总进行荟萃分析。我们的结果表明，年轻患者机械取栓术后预后良好。有必要进一步研究这些结局，以便进行更高效能的分析，为临床医生提供关于该患者年龄组队列结局的更充分信息。
