| خلاصه مقاله | Background and Aims:
While there are high-quality evidences comparing the efficacy of interventional treatments in Anterior Circulation Stroke (ACS)
and Posterior Circulation Stroke (PCS), due to the various nature and outcomes of the studies it is necessary to reach a
consensus on the outcomes. We conducted this Umbrella review to provide a comprehensive comparison of the efficacy and
potential consequences of interventional techniques used in ACS and PCS.
Methods:
To find comparative systematic reviews reporting on patients treated with Mechanical Thrombectomy (MT) or Intra-Venous
Thrombolysis (IVT) in ACS vs PCS, databases including PubMed, Scopus, and WOS were systematically searched. We assessed
successful or full recanalization by thrombolysis in cerebral infarction (TICI) ≥ 2b, 90-day functional status, symptomatic
intracranial hemorrhage (sICH), and 90-day mortality as our outcome of interest. For the risk of bias evaluation, the ROBIS tool
was applied.
Results:
A total of 5 studies were included. MT and IVT was evaluated in 3 and 2 studies, respectively. In terms of Successful
recanalization, MT is equally beneficial in ACS and PCS. In terms of 90-day functional status, the PCS by MT has statistically
lower outcomes. MT in PCS is associated to a lower risk of sICH and a higher rate of mortality during 90 days. IVT is associated
with significant lower risk of sICH and better outcomes of 90-day functional status in PCS.
Conclusions:
According to the reports, MT is the recommended and safer intervention in ACS patients because of better functional
outcomes and lesser mortality and IVT is the recommended intervention in PCS patients. |