Does endovascular intervention combined with medical management improve outcomes of patients with acute ischemic stroke?

Presenter: Erica Jones, M.D., M.P.H.

Link to PowerPoint Presentation: Journal Club

Clinical Question:

Does endovascular intervention combined with medical management, including IV tissue plasminogen activator, improve outcomes of patients with acute ischemic stroke?

Journal Club Article: 

Chen CJ, Ding D, Starke RM, Mehndiratta P, Crowley RW, Liu KC, Southerland AM, Worrall BB. Endovascular vs medical management of acute ischemic stroke.  Neurology. 2015 Dec 1;85(22):1980-90.

 

Methodology:
A systematic literature review was performed, and multicenter, prospective RCTs published from January 1, 2013, to May 1, 2015, directly comparing endovascular therapy to medical management for patients with acute ischemic stroke were included. Meta-analyses of modified Rankin Scale (mRS) and mortality at 90 days and symptomatic intracranial hemorrhage (sICH) for endovascular therapy and medical management were performed.

 

Study Conclusions:

This meta-analysis provides strong evidence that endovascular intervention combined
with medical management, including IV tissue plasminogen activator for eligible patients, improves the outcomes of appropriately selected patients with acute ischemic stroke in the setting of LVO.

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