• About
  • Masthead
  • License Content
  • Advertise
  • Submit Press Release
  • RSS/Email List
  • 2MM Podcast
  • Write for us
  • Contact Us
2 Minute Medicine
No Result
View All Result

No products in the cart.

SUBSCRIBE
  • Specialties
    • All Specialties, All Recent Reports
    • Cardiology
    • Chronic Disease
    • Dermatology
    • Emergency
    • Endocrinology
    • Gastroenterology
    • Imaging and Intervention
    • Infectious Disease
    • Nephrology
    • Neurology
    • Obstetrics
    • Oncology
    • Ophthalmology
    • Pediatrics
    • Pharma
    • Preclinical
    • Psychiatry
    • Public Health
    • Pulmonology
    • Rheumatology
    • Surgery
  • AI Roundup
  • Pharma
  • The Scan+
  • Classics™+
    • 2MM+ Online Access
    • Paperback and Ebook
  • Rewinds
  • Visual
  • Podcasts
  • Partners
    • License Content
    • Submit Press Release
    • Advertise with Us
  • Account
    • Subscribe
    • Sign-in
    • My account
2 Minute Medicine
  • Specialties
    • All Specialties, All Recent Reports
    • Cardiology
    • Chronic Disease
    • Dermatology
    • Emergency
    • Endocrinology
    • Gastroenterology
    • Imaging and Intervention
    • Infectious Disease
    • Nephrology
    • Neurology
    • Obstetrics
    • Oncology
    • Ophthalmology
    • Pediatrics
    • Pharma
    • Preclinical
    • Psychiatry
    • Public Health
    • Pulmonology
    • Rheumatology
    • Surgery
  • AI Roundup
  • Pharma
  • The Scan+
  • Classics™+
    • 2MM+ Online Access
    • Paperback and Ebook
  • Rewinds
  • Visual
  • Podcasts
  • Partners
    • License Content
    • Submit Press Release
    • Advertise with Us
  • Account
    • Subscribe
    • Sign-in
    • My account
SUBSCRIBE
2 Minute Medicine
Subscribe
Home All Specialties Imaging and Intervention

Meta-analysis suggests endovascular therapy improves stroke outcomes

byBenjamin Laguna, MDandAaron Maxwell, MD
December 6, 2014
in Imaging and Intervention, Neurology
Reading Time: 3 mins read
0
Share on FacebookShare on Twitter

1. A meta-analysis of prospective randomized control trials of endovascular therapies for ischemic stroke demonstrated that endovascular therapies, when compared to standard medical management alone, improved patient outcomes at 90 days after intervention.

2. The demonstrated improvement of endovascular therapy over medical management was greatest among patients who had confirmed large vessel occlusion prior to treatment.

Evidence Rating Level: 2 (Good)

Study Rundown: To date, trials comparing endovascular therapy with medical management for acute ischemic stroke have failed to demonstrate superiority of either treatment. Many of these trials were criticized; however, for their use of older techniques and/or equipment, as well as for the subset of patients included in the treatment arms. In particular, stroke patients enrolled in prior multicenter trials often did not have large vessel occlusion (LVO) confirmed by imaging prior to intervention, and thus patient selection for endovascular therapy may have been suboptimal. More recent trials have begun to suggest improved outcomes using endovascular therapy, with the most recent being the Multicenter Randomized Clinical trial of Endovascular treatment for Acute Ischemic stroke in the Netherlands (MR CLEAN). In the present study, a meta-analysis was conducted using all prospective randomized controlled trials (RCTs) comparing endovascular therapy with medical management in the treatment of acute ischemic stroke. The study’s results suggested that patients who undergo endovascular therapy have better outcomes per the modified Rankin Scale (mRS)—a validated scale of post-stroke disability—than those who receive standard medical care. This finding was confirmed among patients both with and without confirmed LVO, though those with LVO confirmation had greater benefit. No difference in mortality was noted between the two treatment arms of the study, though there was a trend toward significance among those with LVO confirmation. These findings suggest a potential role for endovascular therapy in patients with acute ischemic stroke due to improved patient outcomes, something that was last advanced with the introduction of intravenous tissue plasminogen activator (tPA) use. This study was limited by the fact that the analyzed studies all involved different patient populations and utilized of inclusion criteria, creating a heterogeneous analysis group. In addition, the prospective cohorts being analyzed were generally small in size, with the largest being the most recent MR CLEAN cohort; this may have skewed results toward more recent findings. Future RCTs with a large patient population are warranted to validate these promising results.

Click to read the study in Journal of Neurointerventional Surgery

Relevant reading:  Endovascular therapy after intravenous t-PA versus t-PA alone for stroke.

RELATED REPORTS

Cerebral embolic protection does not decrease stroke incidence in TAVI patients

Seventh cervical nerve neurotomy may augment speech therapy in patients with chronic aphasia post-stroke

#VisualAbstract: Routine Cerebral Embolic Protection Did Not Reduce Stroke Incidence during Transcatheter Aortic-Valve Implantation

In-Depth [meta-analysis]: In this study, prospective RCTs of endovascular therapy for acute ischemic stroke were compared to standard medical management alone, which may have included peripheral intravenous tPA use. A total of 6 trials met full inclusion criteria. Following data aggregation, 2 separate data sets were compiled: one in which patients had confirmed LVO by imaging prior to intervention (n=1183), and a second including all patients regardless of LVO imaging confirmation (n=1903). The primary endpoint for both sets was an mRS of 0-2 at 90 days, scores indicating no disability or minor disability. Secondary outcomes included 90-day mRS of 0-1, 90-day mRS of 0-3, and overall mortality. Among those with LVO imaging confirmation, a significantly greater number of patients reached the primary endpoint following endovascular therapy when compared to patients assigned to medical management alone (OR 1.67, 95% CI 1.29-2.16, P=0.001). Similar results were obtained when patients without LVO confirmation were included in the analysis (OR 1.27, 95% CI 1.05 to 1.54, p=0.019). No difference in mortality was noted in either dataset; however, there was a trend toward significance among those with LVO confirmation when compared to those without.

More from this author: Magnetic resonance imaging may aid detection of pulmonary hypertension, Breast ultrasound may improve cancer detection in dense breasts, Optical molecular imaging improves lesion localization during liver procedures

Image: PD

©2014 2 Minute Medicine, Inc. All rights reserved. No works may be reproduced without expressed written consent from 2 Minute Medicine, Inc. No article should be construed as medical advice and is not intended as such by the authors, editors, staff or by 2 Minute Medicine, Inc.

Tags: endovascular therapyinterventional neurologystroke
Previous Post

Surgical site anesthetic infusion may enhance analgesia after mastectomy

Next Post

High frequency of germline mutations observed in triple negative breast cancers

RelatedReports

Cerebral protection device effective in patients undergoing transcatheter aortic valve implantation
Cardiology

Cerebral embolic protection does not decrease stroke incidence in TAVI patients

July 8, 2025
Intensive rehabilitation not superior to traditional therapy for arm function after stroke
Chronic Disease

Seventh cervical nerve neurotomy may augment speech therapy in patients with chronic aphasia post-stroke

July 5, 2025
#VisualAbstract: Routine Cerebral Embolic Protection Did Not Reduce Stroke Incidence during Transcatheter Aortic-Valve Implantation
All Specialties

#VisualAbstract: Routine Cerebral Embolic Protection Did Not Reduce Stroke Incidence during Transcatheter Aortic-Valve Implantation

July 3, 2025
Quick Take: Functional Outcome of Intravenous Thrombolysis in Patients With Lacunar Infarcts in the WAKE-UP Trial
Weekly Rewinds

2 Minute Medicine Rewind June 30, 2025

June 30, 2025
Next Post
High frequency of germline mutations observed in triple negative breast cancers

High frequency of germline mutations observed in triple negative breast cancers

BRAF V600E mutations linked with increased mortality in thyroid cancer

Adherence to a Mediterranean diet linked to longer telomere length

Exercise improves aromatase inhibitor-induced arthralgia in breast cancer survivors

Exercise improves aromatase inhibitor-induced arthralgia in breast cancer survivors

2 Minute Medicine® is an award winning, physician-run, expert medical media company. Our content is curated, written and edited by practicing health professionals who have clinical and scientific expertise in their field of reporting. Our editorial management team is comprised of highly-trained MD physicians. Join numerous brands, companies, and hospitals who trust our licensed content.

Recent Reports

  • Oral vancomycin may be effective for pouchitis in inflammatory bowel disease
  • Inebilizumab improves outcome in patients generalized myasthenia gravis
  • Medbridge turns any phone into a motion-capture coach for at-home rehab
License Content
Terms of Use | Disclaimer
Cookie Policy
Privacy Statement (EU)
Disclaimer

© 2021 2 Minute Medicine, Inc. - Physician-written medical news.

  • Specialties
    • All Specialties, All Recent Reports
    • Cardiology
    • Chronic Disease
    • Dermatology
    • Emergency
    • Endocrinology
    • Gastroenterology
    • Imaging and Intervention
    • Infectious Disease
    • Nephrology
    • Neurology
    • Obstetrics
    • Oncology
    • Ophthalmology
    • Pediatrics
    • Pharma
    • Preclinical
    • Psychiatry
    • Public Health
    • Pulmonology
    • Rheumatology
    • Surgery
  • AI Roundup
  • Pharma
  • The Scan
  • Classics™
    • 2MM+ Online Access
    • Paperback and Ebook
  • Rewinds
  • Visual
  • Podcasts
  • Partners
    • License Content
    • Submit Press Release
    • Advertise with Us
  • Account
    • Subscribe
    • Sign-in
    • My account
No Result
View All Result

© 2021 2 Minute Medicine, Inc. - Physician-written medical news.