Efficacy of Intra-Arterial Fibrinolysis for Acute Ischemic Stroke Meta-Analysis of Randomized Controlled Trials

摘要: Background and Purpose— Although intra-arterial (IA) fibrinolysis for acute ischemic stroke has been clinically available many years, it is not a therapy approved by the US Food Drug Administration. Single, randomized, clinical trials (RCTs) have suggested beneficial effects, but no single RCT demonstrated that IA yields increases in both good (modified Rankin Scale score 0 to 2) excellent 1) outcomes when compared with control group. Relatively few participants inadequate statistical power RCTs may contributed this difficulty. Method— We performed systematic literature search identified of stroke. Multiple were analyzed, emphasis on at 90 days or trial end point. Results— The 5 395 comparing control. was associated increased (odds ratio=2.05; 95% CI, 1.33 3.14; P =0.001) ratio=2.14; 1.31 3.51; =0.003) outcomes. For additional points, frequencies minimal neurologic deficit (National Institutes Health Stroke 1), impairment activities daily living (Barthel Index 100 95 100), recanalization. radiological symptomatic intracerebral hemorrhage. However, there difference mortality between groups. Conclusions— Formal meta-analysis suggests substantially recanalization rates Increased hemorrhage are any increase mortality.