Dados do Trabalho

Título

Emergency thrombectomy or thrombolysis for acute large vessel ischemic stroke

Objetivo

The purpose of this research is to assist healthcare professionals in deciding the appropriate procedure between thrombectomy or thrombolysis for patients with acute large vessel ischemic stroke in the emergency intensive care.

Métodos

The methodology in this study involved a review with meta-analysis using the keywords: ("ACUTE ISCHAEMIC STROKE") AND (“EMERGENCY”) AND (“THROMBECTOMY OR THROMBOLYSIS") AND (“LARGE VESSEL”).

Resultados

Based on the analysis of a study of 240 patients, 80 received the treatment. The combination of endovascular thrombectomy and intravenous thrombolysis (IVT) achieved a reduction in disability (modified Rankin Scale score, 0-1) of 48.1%, while non-perfusion was 21.3%. In another study among 204 patients with acute stroke due to large vessel occlusion, mechanical thrombectomy alone compared with intravenous thrombolysis combined and mechanical thrombectomy failed to demonstrate noninferiority for favorable functional outcomes (difference, 2.1% [1-sided 97.5% CI, -11.4% to ∞]; odds ratio, 1.09 [1-sided 97.5% CI, 0.63 to ∞]; P = 0.18 for noninferiority).
Furthermore, an analysis of 36,123 patients found greater efficacy of TM alone in terms of successful recanalization (RR 1.06, 95% CI 1.03 to 1.09), mortality (RR 0.75, 95% CI 0.68-0.82).

Conclusão

In conclusion, mechanical thrombectomy achieved better results in acute large vessel ischemic stroke than intravenous thrombolysis.