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NeVa 机械血栓切除装置治疗急性缺血性脑卒中的安全性和有效性:系统评价和荟萃分析。

The safety and efficacy of NeVa mechanical thrombectomy device in acute ischemic stroke: A systematic review and meta-analysis.

机构信息

Department of Neurosurgery, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.

Student Research Committee, Qom University of Medical Sciences, Qom, Iran.

出版信息

J Clin Neurosci. 2024 Dec;130:110892. doi: 10.1016/j.jocn.2024.110892. Epub 2024 Oct 28.

Abstract

BACKGROUND

Recent favorable cohort studies on endovascular therapy for ischemic stroke have predominantly utilized NeVa thrombectomy (NeVa stent retrievers. We carried out a systematic review and meta-analysis to investigate the efficacy and safety of this second-generation stent retriever in acute ischemic stroke patients.

METHOD

We conducted the study according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The electronic databases of PubMed, Embase, and Scopus were searched until 26 November 2023 and was updated on August 1, 2024.

RESULTS

This meta-analysis systematically investigated 11 studies with a total of 805 patients suffering from ischemic stroke. The mean age of participants across the studies ranged from 65 to 77 years with a male preponderance of 50.16 %. While ten studies reported on the etiology of strokes, some studies reported the risk factors such as hypertension, dyslipidemia, diabetes, history of coronary artery disease, and previous stroke. The results of our study indicate that the all-hemorrhagic complications rate was 0.32 (95 %CI: 0.18-0.45), while the complete arterial recanalization rate was 0.76 [95 %CI: 0.49-1.04]. The overall recanalization rate was found to be 0.97 [95 %CI: 0.94-1.00]. Moreover, the postoperative hemorrhage rate was 0.28 [95 %CI: 0.14-0.41], while the repeated re-thrombosis rate was 0.01 [95 %CI: -0.01-0.03]. Lastly, the vasospasm rate was calculated to be 0.09 [95 %CI: -0.03-0.21].

CONCLUSION

NeVa™ is a safe option capable of achieving a high rate of recanalization and functional independence.

ABBREVIATIONS

PRISMA, Preferred Reporting Items for Systematic Reviews and Meta-Analyses; PROSPERO, International Prospective Register of Systematic Reviews; NeVa™, NeVa Thrombectomy; ICH, Intracranial Hemorrhage; mTICI, modified Thrombolysis in Cerebral Infarction; mRS, modified Rankin Scale; ACA, Anterior Cerebral Artery; MCA, Middle Cerebral Artery; PCA, Posterior Cerebral Artery; ICA, Internal Carotid Artery; NIHSS, National Institutes of Health Stroke Scale.

摘要

背景

最近关于缺血性卒中血管内治疗的有利队列研究主要采用 NeVa 血栓切除术(NeVa 支架取栓器)。我们进行了系统评价和荟萃分析,以调查这种第二代支架取栓器在急性缺血性卒中患者中的疗效和安全性。

方法

我们根据系统评价和荟萃分析的首选报告项目(PRISMA)指南进行了这项研究。电子数据库 PubMed、Embase 和 Scopus 被检索至 2023 年 11 月 26 日,并于 2024 年 8 月 1 日更新。

结果

这项荟萃分析系统地调查了 11 项共 805 例缺血性卒中患者的研究。研究参与者的平均年龄在 65 至 77 岁之间,男性占 50.16%。虽然有 10 项研究报告了卒中的病因,但有些研究报告了高血压、血脂异常、糖尿病、冠状动脉疾病史和既往卒中的风险因素。我们的研究结果表明,所有出血性并发症发生率为 0.32(95%CI:0.18-0.45),而完全动脉再通率为 0.76 [95%CI:0.49-1.04]。总的再通率为 0.97 [95%CI:0.94-1.00]。此外,术后出血发生率为 0.28 [95%CI:0.14-0.41],而重复再血栓形成率为 0.01 [95%CI:-0.01-0.03]。最后,血管痉挛发生率计算为 0.09 [95%CI:-0.03-0.21]。

结论

NeVa™是一种安全的选择,能够实现高再通率和功能独立性。

缩写

PRISMA,系统评价和荟萃分析的首选报告项目;PROSPERO,国际系统评价注册中心;NeVa™,NeVa 血栓切除术;ICH,颅内出血;mTICI,改良脑梗死溶栓;mRS,改良 Rankin 量表;ACA,大脑前动脉;MCA,大脑中动脉;PCA,大脑后动脉;ICA,颈内动脉;NIHSS,国立卫生研究院卒中量表。

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