Abstract TP1: Recanalization and Clinical Outcomes correlation in Acute Stroke: Meta Analysis
Objective: Intravenous thrombolysis is still the only FDA approved therapy for acute ischemic stroke since the NINDS trial. The introduction of more aggressive and alternative acute stroke interventions and techniques has given rise to wide body of contemporary literature reporting patient outcomes across the various treatment modalities; these outcomes have yet to be comprehensively quantified and reviewed. The existing data is still lacking solid evidence of correlation between successful recanalization and good outcome.
Methods: Data were collected through Medline search. Analysis of 140 articles published between the years 1985 - 2011 was done to compare clinical outcomes, complication and mortality rates between non-revascularized and revascularized groups in the setting of acute stroke therapy. Search key words included recanalization, reperfusion, thrombolysis, modified Rankin Scale (mRS), in combination with ischemic stroke and cerebral ischemia.
Results: Pooled analysis of 140 studies including 4,313 patients conveyed recanalization rate. Based on recanalization status, mRS was accessible in 110 studies, Symptomatic Intracranial Hemorrhage (sICH) in 60 studies and mortality rate in 86 studies. Patients with successful recanalization had better chance of having good functional outcome measured by mRS at 90 days (OR, 4.99; 95% CI, 4.21 to 5.91). sICH rate was not statistically different between the two groups (OR, 1.25; 95% CI, 0.90 to 1.73). Mortality rate was less in patients with successful recanalization compared with non-recanalized (OR, 2.77; 95% CI, 2.27 to 3.38).
Interpretation: Our results suggest a strong relationship between successful revascularization and better functional outcome with less mortality rate.
- © 2012 by American Heart Association, Inc.