Anagnostopoulos Iason-Stefanos, Georgakopoulou Vasiliki Epameinondas, Trakas Ilias, Papalexis Petros, Trakas Nikolaos, Spandidos Demetrios A, Fotakopoulos George
Medical School, University of Ioannina, 45500 Ioannina, Greece.
Department of Infectious Diseases and COVID-19 Unit, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece.
Exp Ther Med. 2023 Jun 23;26(2):377. doi: 10.3892/etm.2023.12076. eCollection 2023 Aug.
Patients with acute ischemic stroke (AIS) presenting mild symptoms with a low National Institutes of Health Stroke Scale (NIHSS) score ≤8 and also found to have an intracranial large vessel occlusion (LVO) undergo endovascular thrombolysis (ET) or medical management alone. The current study aimed to evaluate the safety and effectiveness of medical management vs. ET therapy among patients with mild AIS symptoms (NIHSS score ≤8) accompanied by LVO. The present meta-analysis included articles involving mild AIS, LVO, thrombectomy/ET and medical management alone published in full-text form (from 1980 to 2022). Collected variables included: First author name, covered study period, publication year, the total number of patients and age, number of males, presence of diabetes mellitus, hypertension, atrial fibrillation, prior ischemic stroke, location, NIHSS of admission, modified Rankin scale, bleeding, morbidity and mortality. After the initial search and applying all exclusion and inclusion criteria, eight articles were left in the final article pool. The total number of patients who underwent ET was 569, compared with 1097 with medical management for LVO strokes with minimal symptoms. The findings of the present meta-analysis study point out that ET management may be associated with a high risk of bleeding and mortality in patients with LVO presenting with mild symptoms (NIHSS score ≤8).
急性缺血性卒中（AIS）患者若症状轻微且美国国立卫生研究院卒中量表（NIHSS）评分较低（≤8分），同时发现存在颅内大血管闭塞（LVO），则接受血管内溶栓（ET）或单纯药物治疗。本研究旨在评估单纯药物治疗与ET治疗对伴有LVO的轻度AIS症状（NIHSS评分≤8分）患者的安全性和有效性。本荟萃分析纳入了以全文形式发表的涉及轻度AIS、LVO、血栓切除术/ET及单纯药物治疗的文章（时间跨度为1980年至2022年）。收集的变量包括：第一作者姓名、研究涵盖时间段、发表年份、患者总数及年龄、男性数量、糖尿病、高血压、心房颤动、既往缺血性卒中的存在情况、病变部位、入院时的NIHSS评分、改良Rankin量表评分、出血情况、发病率和死亡率。经过初步检索并应用所有排除和纳入标准后，最终纳入文章库的文章有8篇。接受ET治疗的患者总数为569例，而接受单纯药物治疗的LVO轻症卒中患者有1097例。本荟萃分析研究结果指出，对于伴有轻度症状（NIHSS评分≤8分）的LVO患者，ET治疗可能与较高的出血风险和死亡率相关。
